| Asya Rivinson Lcsw Pc | |
|
697 Valley St Suite B1 Maplewood NJ 07040-2641 | |
| (800) 870-6244 | |
| Not Available |
| Full Name | Asya Rivinson Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 697 Valley St, Maplewood, New Jersey |
| Authorized Official Name and Position | Asya Rivinson (BUSINESS OWNER) |
| Authorized Official Contact | 8008706244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Asya Rivinson Lcsw Pc 96 Elm St Millburn NJ 07041-2112 Ph: (800) 870-6244 | Asya Rivinson Lcsw Pc 697 Valley St Suite B1 Maplewood NJ 07040-2641 Ph: (800) 870-6244 |
| NPI Number | 1780094128 |
|---|---|
| Provider Enumeration Date | 05/07/2014 |
| Last Update Date | 03/22/2017 |
| Medicare PECOS PAC ID | 5092038265 |
|---|---|
| Medicare Enrollment ID | O20141218001759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780094128 | NPI | - | NPPES |
| 079083 | Other | NY | LCSW |
| 44SC05647900 | Other | NJ | LCSW |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 079083 (New York) | Primary |
| 261Q00000X | Clinic/center | 44SC05647900 (New Jersey) | Secondary |
| Provider Name | Asya Rivinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093974339 PECOS PAC ID: 6204003528 Enrollment ID: I20120126000742 |
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