MEDICARE: MRS. RENA YALEN MSW, 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	44SC04311900	NJ
2	1041C0700X	Clinical Social Worker	R050540	NY

General Provider Information

NPI Number	:	1982737888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RENA YALEN MSW, LCSW

Provider Business Mailing Address
First Line	:	360 E 88TH ST APT 36B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-4993
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 CEDAR LN
Second Line	:	SUITE 2
City	:	TEANECK
State	:	NJ
Zip	:	07666-3444
Country	:	US
Telephone Number	:	201-290-8600
Fax Number	:

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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