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General NPI Number Information
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NPI Number | 1801540224
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Entity Type | Organization
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Legal Business Name | JENNI LEVINE DRISCOLL
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 319 E RIDGEWOOD AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3301
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Country | US
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Telephone | 551-305-9600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 537
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City | MIDLAND PARK
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State | NJ
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Zip | 07432-0537
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER DRISCOLL
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Credential |
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Telephone | 551-305-9600
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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 |
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License Number State |
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