Healthcare Provider Details

I. General information

NPI: 1568996742
Provider Name (Legal Business Name): JENNIFER ELINOR HUTCHINSON LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 OAK ST
PATERSON NJ
07501-3108
US

IV. Provider business mailing address

175 FOREST AVE
GLEN RIDGE NJ
07028-2415
US

V. Phone/Fax

Practice location:
  • Phone: 973-321-1000
  • Fax:
Mailing address:
  • Phone: 973-495-4107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06137400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: