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NPI Code Detail

MEDICARE: RUTH VIERA

MEDICARE: RUTH VIERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker44SL05624300NJ

General Provider Information

NPI Number : 1003293853
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH VIERA
Provider Business Mailing Address
First Line : 411 CUMBERLAND AVENUE
Second Line :
City : TEANECK
State : NJ
Zip : 07666
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 590 N 7TH ST
Second Line :
City : NEWARK
State : NJ
Zip : 07107-2522
Country : US
Telephone Number : 973-596-5101
Fax Number : 973-639-5049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2015
Last Update Date : 04/30/2015

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Directions to “ RUTH VIERA ” Practice Location

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