Provider Demographics
NPI:1790734390
Name:REIFMAN, TOBY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TOBY
Middle Name:
Last Name:REIFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4413
Mailing Address - Country:US
Mailing Address - Phone:301-256-9720
Mailing Address - Fax:201-894-5594
Practice Address - Street 1:310 CEDAR LN
Practice Address - Street 2:SUITE 1
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3441
Practice Address - Country:US
Practice Address - Phone:201-928-2889
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001905001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ692372Medicare ID - Type Unspecified