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NPI Code Detail

MEDICARE: JOANNE SKIBA REYNOLDS LCSW

MEDICARE: JOANNE SKIBA REYNOLDS 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
11041C0700XClinical Social Worker44SC00865900NJ

General Provider Information

NPI Number : 1346470481
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNE SKIBA REYNOLDS LCSW
Provider Business Mailing Address
First Line : 35 LONG ST
Second Line : SUITE UL5
City : JERSEY CITY
State : NJ
Zip : 07305-2726
Country : US
Telephone Number : 201-306-3578
Fax Number :
Provider Business Practice Location Address
First Line : 150 WEST END AVENUE
Second Line : SUITE UL5
City : SOMERVILLE
State : NJ
Zip : 08876-3005
Country : US
Telephone Number : 201-306-3578
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2009
Last Update Date : 03/24/2016

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