1346875077 NPI number — MR. RICARDO JAVIER VARGAS ECHEVARRIA SR. MASTER IN SOCIAL WOR

Table of content: DANA E SILVER OT (NPI 1932674702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346875077 NPI number — MR. RICARDO JAVIER VARGAS ECHEVARRIA SR. MASTER IN SOCIAL WOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VARGAS ECHEVARRIA
Provider First Name:
RICARDO
Provider Middle Name:
JAVIER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
MASTER IN SOCIAL WOR
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VARGAS-ECHEVARRIA
Provider Other First Name:
RICARDO
Provider Other Middle Name:
JAVIER
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
SR.
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1346875077
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 FRANK B MURRAY ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-285-8586
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 FRANK B MURRAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01103-1106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-285-8586
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2020

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 6183108 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 6183108 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6183108 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".