Basic Information
| Provider Information | |||||||||
| NPI: | 1427413210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARACCIO | ||||||||
| FirstName: | STEVE | ||||||||
| MiddleName: | LAZARUS | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 85 BECKWITH PL | ||||||||
| Address2: | |||||||||
| City: | RUTHERFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070701207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016742950 | ||||||||
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| Practice Location | |||||||||
| Address1: | 610 VALLEY HEALTH PLZ | ||||||||
| Address2: | |||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076523607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2012658200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2015 | ||||||||
| LastUpdateDate: | 12/21/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 44SL06059000 | NJ | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.