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NPI Code Detail

MEDICARE: JENNIFER RIENHARDT LCSW

MEDICARE: JENNIFER RIENHARDT 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 Worker073704NY

General Provider Information

NPI Number : 1548823297
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER RIENHARDT LCSW
Provider Business Mailing Address
First Line : 27 RANDOLPH RD
Second Line :
City : HOWELL
State : NJ
Zip : 07731-8611
Country : US
Telephone Number : 732-797-9386
Fax Number :
Provider Business Practice Location Address
First Line : 5075 W SENECA TPKE
Second Line :
City : SYRACUSE
State : NY
Zip : 13215-3216
Country : US
Telephone Number : 732-797-9386
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2019
Last Update Date : 04/18/2019

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