MEDICARE: MRS. ROBERTA R. GELFAND LCSW

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
1	1041C0700X	Clinical Social Worker	016448	CT
2	1041C0700X	Clinical Social Worker	094434-0	NY
3	1041C0700X	Clinical Social Worker	44SC06057500	NJ

General Provider Information

NPI Number	:	1255800066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBERTA R. GELFAND LCSW

Provider Business Mailing Address
First Line	:	PO BOX 462
Second Line	:
City	:	FAIR LAWN
State	:	NJ
Zip	:	07410-0462
Country	:	US
Telephone Number	:	646-883-4767
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 462
Second Line	:
City	:	FAIR LAWN
State	:	NJ
Zip	:	07410-0462
Country	:	US
Telephone Number	:	646-883-4767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2018
Last Update Date	:	05/28/2026

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