Basic Information
| Provider Information | |||||||||
| NPI: | 1497364202 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIQUEIRA | ||||||||
| FirstName: | BARBARA | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | C4 WOODSIDE GDNS | ||||||||
| Address2: | |||||||||
| City: | ROSELLE PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 072041004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9088757563 | ||||||||
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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: | 07/28/2020 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 44SL06474400 | NJ | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.