MEDICARE: MARGARET VLAZNY MSW, 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
1	1041C0700X	Clinical Social Worker	44SC05271700	NJ

General Provider Information

NPI Number	:	1538283668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET VLAZNY MSW, LCSW

Provider Business Mailing Address
First Line	:	240 E PALISADE AVE APT 11J
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-3161
Country	:	US
Telephone Number	:	201-408-4689
Fax Number	:

Provider Business Practice Location Address
First Line	:	147 COLUMBIA TPKE STE 307
Second Line	:
City	:	FLORHAM PARK
State	:	NJ
Zip	:	07932-2145
Country	:	US
Telephone Number	:	973-236-0020
Fax Number	:

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/08/2007

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