MEDICARE: KIMBERLY SAVINO MCSW

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	44SC05055100	NJ

General Provider Information

NPI Number	:	1619186566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY SAVINO MCSW

Provider Business Mailing Address
First Line	:	22-08 STATE RT 208
Second Line	:	SUITE 16
City	:	FAIR LAWN
State	:	NJ
Zip	:	07410-2609
Country	:	US
Telephone Number	:	201-956-6363
Fax Number	:	201-956-6026

Provider Business Practice Location Address
First Line	:	22-08 STATE RT 208
Second Line	:	SUITE 16
City	:	FAIR LAWN
State	:	NJ
Zip	:	07410-2609
Country	:	US
Telephone Number	:	201-956-6363
Fax Number	:	201-956-6026

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2007

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