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General NPI Number Information
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NPI Number | 1295774982
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Entity Type | Individual
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Provider Name | PAUL ROBERT FINE L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 163 ENGLE ST STE 5
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2530
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Country | US
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Telephone | 201-835-8565
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Fax |
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Provider Business Mailing Address
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Address Line | 1165 W LAURELTON PKWY
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City | TEANECK
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State | NJ
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Zip | 07666-2753
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Country | US
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Telephone | 201-836-8004
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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 | SC01458
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License Number State | NJ
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