Healthcare Provider Details

I. General information

NPI: 1750410924
Provider Name (Legal Business Name): PAULA ANN FRUEH M.S.W., L.C.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32-40 N DEAN ST STE C
ENGLEWOOD NJ
07631-2815
US

IV. Provider business mailing address

64 DWIGHT PL APT A
ENGLEWOOD NJ
07631-3668
US

V. Phone/Fax

Practice location:
  • Phone: 201-233-9802
  • Fax:
Mailing address:
  • Phone: 201-503-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05295600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: