Provider Demographics
NPI:1912745456
Name:MARC PANEPINTO LLC
Entity type:Organization
Organization Name:MARC PANEPINTO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:PANEPINTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-246-0869
Mailing Address - Street 1:45 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2604
Mailing Address - Country:US
Mailing Address - Phone:908-246-0869
Mailing Address - Fax:888-812-6494
Practice Address - Street 1:55 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2225
Practice Address - Country:US
Practice Address - Phone:908-246-0869
Practice Address - Fax:888-812-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty