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NPI Code Detail

MEDICARE: LISA ESTRIN, LCSW

MEDICARE: LISA ESTRIN, 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 Worker44SC00124800NJ

General Provider Information

NPI Number : 1497135966
Entity Type Code : Organization
Provider Name (Legal Business Name) : LISA ESTRIN, LCSW
Provider Business Mailing Address
First Line : 70 HILLTOP RD
Second Line : SUITE 1004
City : RAMSEY
State : NJ
Zip : 07446-1155
Country : US
Telephone Number : 201-327-0005
Fax Number : 774-237-0221
Provider Business Practice Location Address
First Line : 70 HILLTOP RD
Second Line : SUITE 1004
City : RAMSEY
State : NJ
Zip : 07446-1155
Country : US
Telephone Number : 201-327-0005
Fax Number : 774-237-0221
Authorized Official
Title or Position : OWNER
Name : LISA ESTRIN
Credential : LCSW
Telephone Number : 201-327-0005
Provider Enumeration Date : 05/31/2015
Last Update Date : 05/31/2015

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