Nicole Berezny, LSW
Individual provider Active NPI Social Worker · Orange, NJ
NPI 1366820169 · NPPES record last updated May 12, 2015
Key facts
- NPI
- 1366820169
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 44SL05862800 (NJ)
- Practice address
- 395 S Center St
Orange, NJ 07050-3205 - Phone
- (973) 675-3817
- NPI assigned
- May 12, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05862800 | NJ | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL05862800 | NJ | Yes |
Addresses
Primary practice location
395 S Center St
Orange, NJ 07050-3205
Mailing address
395 S Center St
Orange, NJ 07050-3205
Phone (973) 675-3817
Other providers in Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.