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NPI Code Detail

MEDICARE: LEE ANN MARQUARD MSW

MEDICARE: LEE ANN MARQUARD MSW
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
1101YM0800XMental Health Counselor44SL05224500NJ

General Provider Information

NPI Number : 1538286257
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE ANN MARQUARD MSW
Provider Business Mailing Address
First Line : 540 UPPER BLVD
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-1508
Country : US
Telephone Number : 201-670-4825
Fax Number :
Provider Business Practice Location Address
First Line : 1022 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-3209
Country : US
Telephone Number : 973-694-1234
Fax Number : 973-633-0992
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 07/08/2007

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