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NPI Code Detail

MEDICARE: RIDLEN CONSULTING INC

MEDICARE: RIDLEN CONSULTING INC
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 Worker44SC046559NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P2214572OTHERNJOXFORD ID
2220819OTHERNJMANAGED HEALTH NETWORK ID

General Provider Information

NPI Number : 1154314151
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIDLEN CONSULTING INC
Provider Business Mailing Address
First Line : 108 SHERMAN PL
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07307-3730
Country : US
Telephone Number : 201-798-5725
Fax Number : 201-420-0633
Provider Business Practice Location Address
First Line : 600 PAVONIA AVE
Second Line : 3RD FL
City : JERSEY CITY
State : NJ
Zip : 07306-2929
Country : US
Telephone Number : 201-798-5725
Fax Number : 201-420-0633
Authorized Official
Title or Position : PRESIDENT
Name : DR. SYLVIA RIDLEN
Credential : PHD LCSW
Telephone Number : 201-798-5725
Provider Enumeration Date : 08/24/2005
Last Update Date : 08/22/2020

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