1265608350 NPI number — MR. ROZARIO CHEVANA DEVARAJ LCSWR CASAC

Table of content: MR. ROZARIO CHEVANA DEVARAJ LCSWR CASAC (NPI 1265608350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265608350 NPI number — MR. ROZARIO CHEVANA DEVARAJ LCSWR CASAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEVARAJ
Provider First Name:
ROZARIO
Provider Middle Name:
CHEVANA
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSWR CASAC
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:
1265608350
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43-43 BOWNE ST
Provider Second Line Business Mailing Address:
QUEENS COUNSELING SERVICES
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11355
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-461-6393
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43-43 BOWNE ST
Provider Second Line Business Practice Location Address:
QUEENS COUNSELING SERVICES
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-461-6393
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2008

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: 101YA0400X , with the licence number:  9599 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: R051049 , 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)