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NPI Code Detail

MEDICARE: FRAN MICELI

MEDICARE: FRAN MICELI
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
1101YA0400XAddiction (Substance Use Disorder) Counselor37LC00103300NJ
2104100000XSocial Worker44SW00326600NJ

General Provider Information

NPI Number : 1861740565
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRAN MICELI
Provider Business Mailing Address
First Line : 36 SOUTH ST
Second Line :
City : MANASQUAN
State : NJ
Zip : 08736-3440
Country : US
Telephone Number : 732-223-4673
Fax Number : 732-722-7867
Provider Business Practice Location Address
First Line : 36 SOUTH ST
Second Line :
City : MANASQUAN
State : NJ
Zip : 08736-3440
Country : US
Telephone Number : 732-223-4673
Fax Number : 732-722-7867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2012
Last Update Date : 08/28/2012

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Directions to “ FRAN MICELI ” Practice Location

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