Provider Demographics
NPI:1992200661
Name:PAPKE, MAUREEN REILLY
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:REILLY
Last Name:PAPKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W PARK AVE APT 25D
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-3638
Mailing Address - Country:US
Mailing Address - Phone:908-872-6259
Mailing Address - Fax:
Practice Address - Street 1:14 ESTAUGH AVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-1414
Practice Address - Country:US
Practice Address - Phone:856-767-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057657001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical