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General NPI Number Information
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NPI Number | 1518083534
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Entity Type | Individual
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Provider Name | ROBERT A. MIELIWOCKI M.S.W.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 24 ELM ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-8802
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Country | US
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Telephone | 974-644-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 44 LANDING TRL
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City | DENVILLE
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State | NJ
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Zip | 07834-1015
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Country | US
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Telephone | 973-627-2962
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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 | SC 08341
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License Number State | NJ
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