MEDICARE: MARIA DECENA

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	104100000X	Social Worker	44SL05680500	NJ

General Provider Information

NPI Number	:	1316246465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DECENA

Provider Business Mailing Address
First Line	:	1070 MORRIS AVE APT 1220
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-7161
Country	:	US
Telephone Number	:	908-906-5676
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 SOUTH AVE E
Second Line	:
City	:	CRANFORD
State	:	NJ
Zip	:	07016-3246
Country	:	US
Telephone Number	:	908-497-3903
Fax Number	:

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

Provider Enumeration Date	:	03/15/2011
Last Update Date	:	03/15/2011

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Directions to “ MARIA DECENA ” Practice Location

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