1467720805 NPI number — MISS ANDREA ESCALERA ESCALERA SOCIAL WORKER

Table of content: MISS ANDREA ESCALERA ESCALERA SOCIAL WORKER (NPI 1467720805)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467720805 NPI number — MISS ANDREA ESCALERA ESCALERA SOCIAL WORKER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESCALERA
Provider First Name:
ANDREA
Provider Middle Name:
ESCALERA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
SOCIAL WORKER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DE CASTRO
Provider Other First Name:
ANDREA
Provider Other Middle Name:
ESCALERA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
SOCIAL WORKER
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1467720805
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GUIPUZCOA 311
Provider Second Line Business Mailing Address:
URB. VALENCIA
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PUERTO RICO
Provider Business Mailing Address Postal Code:
00923
Provider Business Mailing Address Country Code:
UM
Provider Business Mailing Address Telephone Number:
787-328-6564
Provider Business Mailing Address Fax Number:
787-328-6564

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE GUIPUZCOA 311
Provider Second Line Business Practice Location Address:
URB. VALENCIA
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00923-1913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-328-6564
Provider Business Practice Location Address Fax Number:
787-328-6564
Provider Enumeration Date:
12/13/2011

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: 104100000X , with the licence number:  6589 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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