MEDICARE: MS. NINA LERNER L.C.S.W.

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	44SC05335100	NJ

General Provider Information

NPI Number	:	1700073491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NINA LERNER L.C.S.W.

Provider Business Mailing Address
First Line	:	197 VILLAGE RD
Second Line	:
City	:	SOUTH ORANGE
State	:	NJ
Zip	:	07079-2141
Country	:	US
Telephone Number	:	973-953-3993
Fax Number	:	866-594-6140

Provider Business Practice Location Address
First Line	:	111 S ORANGE AVE STE 24
Second Line	:
City	:	SOUTH ORANGE
State	:	NJ
Zip	:	07079-1931
Country	:	US
Telephone Number	:	973-379-2433
Fax Number	:

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

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	11/29/2016

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