MEDICARE: MARIA CAMILLE B NUNEZ LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05544500	NJ

General Provider Information

NPI Number	:	1205697042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CAMILLE B NUNEZ LCSW

Provider Business Mailing Address
First Line	:	288 JONES RD
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-4411
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	288 JONES RD
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-4411
Country	:	US
Telephone Number	:	201-655-8332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2024
Last Update Date	:	01/18/2024

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