Healthcare Provider Details

I. General information

NPI: 1730169970
Provider Name (Legal Business Name): MOSSE BURNS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 KINDERKAMACK RD
ORADELL NJ
07649-2142
US

IV. Provider business mailing address

28 SUTTON DR
HO HO KUS NJ
07423-1025
US

V. Phone/Fax

Practice location:
  • Phone: 201-599-3399
  • Fax:
Mailing address:
  • Phone: 201-445-1948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SC04570400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: