Healthcare Provider Details

I. General information

NPI: 1790734390
Provider Name (Legal Business Name): TOBY REIFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CEDAR LN SUITE 1
TEANECK NJ
07666-3441
US

IV. Provider business mailing address

231 SUNSET AVE
ENGLEWOOD NJ
07631-4413
US

V. Phone/Fax

Practice location:
  • Phone: 201-928-2889
  • Fax:
Mailing address:
  • Phone: 301-256-9720
  • Fax: 201-894-5594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00190500
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: