MEDICARE: MR. DANIEL J ERBACH 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	44SC05956000	NJ

General Provider Information

NPI Number	:	1477693521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL J ERBACH LCSW

Provider Business Mailing Address
First Line	:	6 ESSEX ST APT A4
Second Line	:
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-2643
Country	:	US
Telephone Number	:	551-697-5352
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 ESSEX ST APT A4
Second Line	:
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-2643
Country	:	US
Telephone Number	:	862-201-3180
Fax Number	:

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	06/28/2024

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