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NPI Code Detail

MEDICARE: JACQUELINE SZABO LCSW

MEDICARE: JACQUELINE SZABO 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 Worker44SC05384000NJ

General Provider Information

NPI Number : 1346480704
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE SZABO LCSW
Provider Business Mailing Address
First Line : 120 CHESTNUT ST
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-2504
Country : US
Telephone Number : 201-444-3565
Fax Number : 201-652-1613
Provider Business Practice Location Address
First Line : 120 CHESTNUT ST
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-2504
Country : US
Telephone Number : 201-444-3565
Fax Number : 201-652-1613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2009
Last Update Date : 02/25/2009

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