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General NPI Number Information
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NPI Number | 1801395603
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Entity Type | Individual
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Provider Name | GILA AZAR LOBUE LSW
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Gender | Female
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 300 KIMBALL ST STE 106
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2506
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Country | US
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Telephone | 732-218-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 600 HARBOR BLVD UNIT 834
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City | WEEHAWKEN
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State | NJ
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Zip | 07086-6748
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Country | US
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Telephone | 201-232-3863
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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 | 44SL06320800
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License Number State | NJ
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