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Paul Robert Fine

Social Worker

Behavioral Health & Social Service Providers

163 Engle St Ste 5, Englewood, NJ 07631-2530

PECOS Enrollment

This provider is enrolled in PECOS as PAUL FINE.

Based on the most recent information from CMS, provider Paul Robert Fine is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1295774982
Provider Type
Individual
Full Name
Fine, Paul Robert
Title
Mr.
Credential
L.C.S.W.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/6/2006
Last Updated
12/17/2024

Contact Information

Practice Location

163 Engle St Ste 5, Englewood, NJ 07631-2530

(201) 835-8565

Unlisted Fax

Mailing Location

1165 W Laurelton Pkwy, Teaneck, NJ 07666-2753

(201) 836-8004

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License SC01458 New Jersey

Provider Identifiers

ID	Description	Issuer
ID 0006602	Description Medicaid	Issuer Unlisted New Jersey

Paul Robert Fine

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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