1942518188 NPI number — NELI MARIA ACEVEDO MSW STUDENT

Table of content: NELI MARIA ACEVEDO MSW STUDENT (NPI 1942518188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942518188 NPI number — NELI MARIA ACEVEDO MSW STUDENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ACEVEDO
Provider First Name:
NELI
Provider Middle Name:
MARIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW STUDENT
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:
1942518188
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
91 FORT WASHINGTON AVE APT 22
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10032-4638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-568-3288
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2089 3RD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029-2184
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-828-6144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2010

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: 390200000X , with the licence number:  545163270 , 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)