Active NPI
Angela Buck
- Social Worker
- Newark, NJ
National Provider Identifier
1316573512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL06405900
- Practice address
- 201 Lyons Ave
TLC- Outpatient Program
Newark, NJ 07112 - Phone
- (973) 926-7812
- Fax
- (973) 926-2943
- NPI assigned
- Mar 19, 2020
- Last updated
- Mar 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL06405900 | NJ | Primary |
Addresses
Primary practice location
201 Lyons Ave
TLC- Outpatient Program
Newark, NJ 07112
Mailing address
201 Lyons Ave
TLC- Outpatient Program
Newark, NJ 07112
Phone (973) 926-7812
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL06405900 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1316573512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 LYONS AVE",
"address_2": "TLC- OUTPATIENT PROGRAM",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07112",
"telephone_number": "973-926-7812",
"fax_number": "973-926-2943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 LYONS AVE",
"address_2": "TLC- OUTPATIENT PROGRAM",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07112",
"telephone_number": "973-926-7812",
"fax_number": "973-926-2943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCK",
"first_name": "ANGELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-19",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL06405900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.