1043870108 NPI number — MS. ETTI MIRIRAM HOCHBERG SCHAAP LCSW

Table of content: MS. ETTI MIRIRAM HOCHBERG SCHAAP LCSW (NPI 1043870108)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043870108 NPI number — MS. ETTI MIRIRAM HOCHBERG SCHAAP LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOCHBERG SCHAAP
Provider First Name:
ETTI
Provider Middle Name:
MIRIRAM
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043870108
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
JEWISH FAMILY & CHILDREN'S SERVICES OF NORTHERN NEW JER
Provider Second Line Business Mailing Address:
1485 TEANECK ROAD
Provider Business Mailing Address City Name:
TEANECK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-837-9090
Provider Business Mailing Address Fax Number:
201-837-9393

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
JEWISH FAMILY & CHILDREN'S SERVICES OF NORTHERN NEW JER
Provider Second Line Business Practice Location Address:
1485 TEANECK ROAD
Provider Business Practice Location Address City Name:
TEANECK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-837-9090
Provider Business Practice Location Address Fax Number:
201-837-9393
Provider Enumeration Date:
06/19/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC05861400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)