Healthcare Provider Details

I. General information

NPI: 1669672796
Provider Name (Legal Business Name): DOMINI D ORESKI M.S.W, L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SEARS DR
PARAMUS NJ
07652-3515
US

IV. Provider business mailing address

1 SEARS DR
PARAMUS NJ
07652-3515
US

V. Phone/Fax

Practice location:
  • Phone: 201-982-1266
  • Fax:
Mailing address:
  • Phone: 201-982-1266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC05378
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: