Healthcare Provider Details

I. General information

NPI: 1801099817
Provider Name (Legal Business Name): LYNN SALTIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 WAYNE ST
JERSEY CITY NJ
07302-3513
US

IV. Provider business mailing address

PO BOX 1925
BAYONNE NJ
07002-6925
US

V. Phone/Fax

Practice location:
  • Phone: 201-725-6482
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04511000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: