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NPI Code Detail

MEDICARE: MS. CARLA M. VILCHEZ LOPEZ LMSW

MEDICARE: MS. CARLA M. VILCHEZ LOPEZ LMSW
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 Worker116666NY
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1952937724
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CARLA M. VILCHEZ LOPEZ LMSW
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 : 03/12/2020
Last Update Date : 06/08/2026

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