MEDICARE: MS. LEONORA GASHI

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	104100000X	Social Worker	44SL06678100	NJ

General Provider Information

NPI Number	:	1649842857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEONORA GASHI

Provider Business Mailing Address
First Line	:	30 MILLER LN
Second Line	:
City	:	RIVERSIDE
State	:	CT
Zip	:	06878-1508
Country	:	US
Telephone Number	:	203-898-5908
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 RIVER ST STE 302
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5619
Country	:	US
Telephone Number	:	203-898-5908
Fax Number	:

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

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	07/15/2021

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