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General NPI Number Information
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NPI Number | 1023768496
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Entity Type | Individual
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Provider Name | ERNEST ALBERT STAFFORD JR. MSW
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Gender | Male
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 519 WEST ST
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City | CAMDEN
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State | NJ
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Zip | 08103-3522
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Country | US
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Telephone | 856-968-2320
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Fax | 856-968-2317
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Provider Business Mailing Address
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Address Line | 103 TORRINGTON LN
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City | WILLINGBORO
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State | NJ
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Zip | 08046-3611
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Country | US
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Telephone | 609-835-4429
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SL06774200
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License Number State | NJ
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