Healthcare Provider Details

I. General information

NPI: 1972795375
Provider Name (Legal Business Name): CHRISTINE LEONIDES BARTON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 12/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 LAKE SHORE DR
HEWITT NJ
07421-2523
US

IV. Provider business mailing address

93 LAKE SHORE DR
HEWITT NJ
07421-2523
US

V. Phone/Fax

Practice location:
  • Phone: 973-718-4344
  • Fax: 973-718-4344
Mailing address:
  • Phone: 973-718-4344
  • Fax: 973-718-4344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05537100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: