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General NPI Number Information
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NPI Number | 1821544859
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Entity Type | Individual
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Provider Name | CALLIE ANN BADER LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 8268 164TH ST
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City | JAMAICA
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State | NY
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Zip | 11432-1121
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Country | US
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Telephone | 201-452-0860
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Fax | 201-391-6863
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Provider Business Mailing Address
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Address Line | 81 BLUEBERRY DR
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City | WOODCLIFF LAKE
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State | NJ
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Zip | 07677-8103
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Country | US
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Telephone | 201-452-0860
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Fax | 201-391-6863
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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 | 098134
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License Number State | NY
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