Individual
ALIDA ANN DERUSSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
455 SUNSET AVE, HAWORTH, NJ 07641-1727
(201) 384-0186
(201) 384-0186
Mailing address
455 SUNSET AVE, HAWORTH, NJ 07641-1727
(201) 384-0186
(201) 384-0186
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
064751
NY
1041C0700X
Clinical Social Worker
Primary
44SC05249200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3805750
AETNA
—
01
—
7750693
AETNA
—
01
—
788115000
MAGELLAN
NJ
01
—
P3513999
OXFORD
NJ
Enumeration date
08/22/2007
Last updated
02/18/2019
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