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NPI Code Detail

MEDICARE: DANIEL SERPICO LCSW

MEDICARE:   DANIEL  SERPICO  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 Worker44SC05809100NJ

General Provider Information

NPI Number : 1548640618
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL SERPICO LCSW
Provider Business Mailing Address
First Line : 18 STARBOARD ST
Second Line :
City : BEACHWOOD
State : NJ
Zip : 08722-2958
Country : US
Telephone Number : 732-773-8832
Fax Number :
Provider Business Practice Location Address
First Line : 509 MAIN ST
Second Line : BLDG C
City : TOMS RIVER
State : NJ
Zip : 08753-7402
Country : US
Telephone Number : 732-773-8832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2015
Last Update Date : 05/17/2019

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Directions to “ DANIEL SERPICO LCSW” Practice Location

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