| Kathryn A Memoli Lcsw | |
|
1924 Route 35 Suite 9b Wall Township NJ 07719-3530 | |
| (732) 986-2880 | |
| Not Available |
| Full Name | Kathryn A Memoli Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 1924 Route 35, Wall Township, New Jersey |
| Authorized Official Name and Position | Kathryn A Memoli (OWNER) |
| Authorized Official Contact | 7329862880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathryn A Memoli Lcsw 1924 Route 35 Suite 9b Wall Township NJ 07719-3530 Ph: (732) 986-2880 | Kathryn A Memoli Lcsw 1924 Route 35 Suite 9b Wall Township NJ 07719-3530 Ph: (732) 986-2880 |
| NPI Number | 1316378714 |
|---|---|
| Provider Enumeration Date | 12/10/2013 |
| Last Update Date | 12/10/2013 |
| Medicare PECOS PAC ID | 8628201720 |
|---|---|
| Medicare Enrollment ID | O20140424002133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316378714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC00397000 (New Jersey) | Primary |
| Provider Name | Kathryn A Memoli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568730687 PECOS PAC ID: 1052578903 Enrollment ID: I20120203000212 |
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