Healthcare Provider Details

I. General information

NPI: 1437794534
Provider Name (Legal Business Name): LOURDES NUNEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 EISENHOWER DR STE 209
PARAMUS NJ
07652-1404
US

IV. Provider business mailing address

24 ZABRISKIE ST
HACKENSACK NJ
07601-4905
US

V. Phone/Fax

Practice location:
  • Phone: 201-843-5218
  • Fax:
Mailing address:
  • Phone: 551-587-9497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SW05146100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: