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NPI Code Detail

MEDICARE: JACQUELINE CONTRERAS

MEDICARE: JACQUELINE CONTRERAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1932379757
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE CONTRERAS
Provider Business Mailing Address
First Line : 579 COURTLANDT AVE
Second Line :
City : BRONX
State : NY
Zip : 10451-5013
Country : US
Telephone Number : 718-485-2100
Fax Number :
Provider Business Practice Location Address
First Line : 579 COURTLANDT AVE
Second Line :
City : BRONX
State : NY
Zip : 10451-5013
Country : US
Telephone Number : 718-485-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2008
Last Update Date : 12/30/2015

Similar Medicare Providers

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1659691962 — DAWN MARIA YUNUS PMHNP
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1386991701 — DAISY GONZALES
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1053744102 — LUCIANA GONZALEZ MSW
Practice Location Address:
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10451-5013
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Directions to “ JACQUELINE CONTRERAS ” Practice Location

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