Healthcare Provider Details

I. General information

NPI: 1982744710
Provider Name (Legal Business Name): PABLO ABREU LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 BEACH CHANNEL DR
ARVERNE NY
11692
US

IV. Provider business mailing address

15015 75TH AVE 2B
FLUSHING NY
11367-2961
US

V. Phone/Fax

Practice location:
  • Phone: 718-945-7150
  • Fax: 718-634-4838
Mailing address:
  • Phone: 718-406-4093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR0574661
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: