MEDICARE: RUBY MASLOWSKI

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

General Provider Information

NPI Number	:	1295443968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUBY MASLOWSKI

Provider Business Mailing Address
First Line	:	19 CLEVELAND ST
Second Line	:
City	:	CALDWELL
State	:	NJ
Zip	:	07006-4909
Country	:	US
Telephone Number	:	917-650-0051
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 CLEVELAND ST
Second Line	:
City	:	CALDWELL
State	:	NJ
Zip	:	07006-4909
Country	:	US
Telephone Number	:	917-650-0051
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	RUBY MASLOWSKI
Credential	:
Telephone Number	:	917-650-0051

Provider Enumeration Date	:	11/10/2022
Last Update Date	:	11/02/2023

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