Provider Demographics
NPI:1962271783
Name:AZER, MARY (LSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:AZER
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 1:18 SUNSET AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2209
Mailing Address - Country:US
Mailing Address - Phone:551-208-6340
Mailing Address - Fax:
Practice Address - Street 1:5 REGENT ST STE 518
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1682
Practice Address - Country:US
Practice Address - Phone:973-994-1011
Practice Address - Fax:973-994-1220
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor