Provider Demographics
NPI:1043365687
Name:DELGIUDICE, TOBIA (MSW LCSW)
Entity type:Individual
Prefix:MR
First Name:TOBIA
Middle Name:
Last Name:DELGIUDICE
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667O YALE WAY
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2026
Mailing Address - Country:US
Mailing Address - Phone:732-586-1139
Mailing Address - Fax:
Practice Address - Street 1:667O YALE WAY
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-2026
Practice Address - Country:US
Practice Address - Phone:732-586-1139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NYR03301911041C0700X
NJ37F100011500106H00000X
NJ44SC000364001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
637847Medicare ID - Type Unspecified