Healthcare Provider Details

I. General information

NPI: 1871151969
Provider Name (Legal Business Name): RAVJIT KAUR SEKHON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 06/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TYLER AVE
CARTERET NJ
07008-1716
US

IV. Provider business mailing address

1 TYLER AVE
CARTERET NJ
07008-1716
US

V. Phone/Fax

Practice location:
  • Phone: 732-512-8306
  • Fax:
Mailing address:
  • Phone: 732-512-8306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05587900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: