MEDICARE: LISA ESTRIN 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
1	1041C0700X	Clinical Social Worker	44SC00124800	NJ

General Provider Information

NPI Number	:	1750681102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA ESTRIN LCSW

Provider Business Mailing Address
First Line	:	70 HILLTOP RD
Second Line	:	SUITE 1004
City	:	RAMSEY
State	:	NJ
Zip	:	07446-1155
Country	:	US
Telephone Number	:	201-327-0005
Fax Number	:	201-327-0157

Provider Business Practice Location Address
First Line	:	70 HILLTOP RD
Second Line	:	SUITE 1004
City	:	RAMSEY
State	:	NJ
Zip	:	07446-1155
Country	:	US
Telephone Number	:	201-327-0005
Fax Number	:	201-327-0157

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

Provider Enumeration Date	:	11/01/2010
Last Update Date	:	11/01/2010

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Directions to “ LISA ESTRIN LCSW” Practice Location

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