MEDICARE: JILLIAN KANE

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	44SC06344900	NJ
2	104100000X	Social Worker	226532	MA

General Provider Information

NPI Number	:	1407507924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN KANE

Provider Business Mailing Address
First Line	:	331 NEWMAN SPRINGS RD STE 220
Second Line	:
City	:	RED BANK
State	:	NJ
Zip	:	07701-5792
Country	:	US
Telephone Number	:	732-807-0877
Fax Number	:	201-751-1680

Provider Business Practice Location Address
First Line	:	87 STATE RT 17 N STE 1-118
Second Line	:
City	:	MAYWOOD
State	:	NJ
Zip	:	07607-1017
Country	:	US
Telephone Number	:	551-996-4450
Fax Number	:	551-996-5729

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

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	12/26/2025

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Directions to “ JILLIAN KANE ” Practice Location

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