Healthcare Provider Details

I. General information

NPI: 1750748141
Provider Name (Legal Business Name): ALBERTO MARRERO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 COURTLANDT AVE BRONX CHILD AND FAMILY MENTAL HEALTH CENTER
BRONX NY
10451
US

IV. Provider business mailing address

579 COURTLANDT AVE BRONX CHILD AND FAMILY MENTAL HEALTH CENTER
BRONX NY
10451
US

V. Phone/Fax

Practice location:
  • Phone: 718-485-2100
  • Fax:
Mailing address:
  • Phone: 718-485-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: