1063673937 NPI number — ANNA BORRERO-PERRY LCSW

Table of content: ANNA BORRERO-PERRY LCSW (NPI 1063673937)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063673937 NPI number — ANNA BORRERO-PERRY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BORRERO-PERRY
Provider First Name:
ANNA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063673937
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
280 MADISON AVE
Provider Second Line Business Mailing Address:
SUITE 610
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-0801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-725-3398
Provider Business Mailing Address Fax Number:
212-868-3331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 MADISON AVE
Provider Second Line Business Practice Location Address:
SUITE 610
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-0801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-725-3398
Provider Business Practice Location Address Fax Number:
212-868-3331
Provider Enumeration Date:
05/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R024086 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P3641098 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com