1053049486 NPI number — MR. RICARDO ANDRES AROCHA LMSW

Table of content: MR. RICARDO ANDRES AROCHA LMSW (NPI 1053049486)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053049486 NPI number — MR. RICARDO ANDRES AROCHA LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AROCHA
Provider First Name:
RICARDO
Provider Middle Name:
ANDRES
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
M

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:
1053049486
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 EAST AVENUE
Provider Second Line Business Mailing Address:
98 EAST BACK OFFICE - LINC PROGRAM
Provider Business Mailing Address City Name:
NORWALK
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-299-1315
Provider Business Mailing Address Fax Number:
203-299-0015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 EAST AVENUE
Provider Second Line Business Practice Location Address:
98 EAST BACK OFFICE - LINC PROGRAM
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-299-1315
Provider Business Practice Location Address Fax Number:
203-299-0015
Provider Enumeration Date:
08/12/2022

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 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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