MEDICARE: TOVA DORNSTEIN

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	44SL06414900	NJ

General Provider Information

NPI Number	:	1336837954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOVA DORNSTEIN

Provider Business Mailing Address
First Line	:	450 W KENNEDY BLVD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1269
Country	:	US
Telephone Number	:	732-901-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 W KENNEDY BLVD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1269
Country	:	US
Telephone Number	:	732-901-6001
Fax Number	:

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

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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Directions to “ TOVA DORNSTEIN ” Practice Location

Language	Start Address	Practice Location

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