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General NPI Number Information
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NPI Number | 1093615734
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Entity Type | Individual
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Provider Name | ELIYAHU SIMMIN LSW
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Gender | Male
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 419 E COUNTY LINE RD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1426
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Country | US
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Telephone | 732-276-5828
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Fax |
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Provider Business Mailing Address
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Address Line | 21 CRIMSON CT
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4068
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Country | US
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Telephone | 845-304-4896
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL07366900
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License Number State | NJ
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