Provider Demographics
NPI:1417374844
Name:GASPARINO, JENNIFER (LSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GASPARINO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3705
Mailing Address - Country:US
Mailing Address - Phone:201-918-5641
Mailing Address - Fax:201-918-5815
Practice Address - Street 1:616 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3705
Practice Address - Country:US
Practice Address - Phone:201-918-5641
Practice Address - Fax:201-918-5815
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05788600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker