MEDICARE: RISHANNABEL UBIERA MSW, LSW

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	44SC06157800	NJ

General Provider Information

NPI Number	:	1700470549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RISHANNABEL UBIERA MSW, LSW

Provider Business Mailing Address
First Line	:	400 LINCOLN AVE
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-2208
Country	:	US
Telephone Number	:	908-000-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 LINCOLN AVE
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-2208
Country	:	US
Telephone Number	:	201-396-8989
Fax Number	:

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

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	02/10/2023

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