1609935683 NPI number — MISS JOVANNA SACHA NIVAR M.S.W

Table of content: MISS JOVANNA SACHA NIVAR M.S.W (NPI 1609935683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609935683 NPI number — MISS JOVANNA SACHA NIVAR M.S.W

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIVAR
Provider First Name:
JOVANNA
Provider Middle Name:
SACHA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.S.W
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:
1609935683
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3620222
Provider Second Line Business Mailing Address:
PACC
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10129-0014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-239-5519
Provider Business Mailing Address Fax Number:
212-971-6041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 W 57TH ST
Provider Second Line Business Practice Location Address:
NEWYORK
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10019-3320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-239-5519
Provider Business Practice Location Address Fax Number:
212-971-6041
Provider Enumeration Date:
12/06/2006

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

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