Provider Demographics
NPI:1073687182
Name:STOBER, CONSTANCE ZAREMBA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:ZAREMBA
Last Name:STOBER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1450
Mailing Address - Country:US
Mailing Address - Phone:073-377-8749
Mailing Address - Fax:973-377-0830
Practice Address - Street 1:124 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1450
Practice Address - Country:US
Practice Address - Phone:073-377-8749
Practice Address - Fax:973-377-0830
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000036001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ675481Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER