Healthcare Provider Details

I. General information

NPI: 1851284699
Provider Name (Legal Business Name): LINNET KYUNG FICCAGLIA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 W LANDIS AVE STE A-2
VINELAND NJ
08360-8133
US

IV. Provider business mailing address

60 W LANDIS AVE STE A-2
VINELAND NJ
08360-8133
US

V. Phone/Fax

Practice location:
  • Phone: 856-772-5809
  • Fax: 856-772-5809
Mailing address:
  • Phone: 856-772-5809
  • Fax: 856-772-5809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07268900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: