MEDICARE: MRS. BARBARA MARY PITOCCO MSW

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		NJ

General Provider Information

NPI Number	:	1437144813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA MARY PITOCCO MSW

Provider Business Mailing Address
First Line	:	375 UNION ST
Second Line	:
City	:	LODI
State	:	NJ
Zip	:	07644-3249
Country	:	US
Telephone Number	:	973-773-9486
Fax Number	:	973-472-2945

Provider Business Practice Location Address
First Line	:	375 UNION ST
Second Line	:
City	:	LODI
State	:	NJ
Zip	:	07644-3249
Country	:	US
Telephone Number	:	973-773-9486
Fax Number	:	973-472-2945

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	12/17/2010

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