Healthcare Provider Details

I. General information

NPI: 1649663097
Provider Name (Legal Business Name): MS. JOANNA SILVIA WELSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2015
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 CAESAR PL # PH
BRONX NY
10473-1868
US

IV. Provider business mailing address

2047 CAESAR PL # PH
BRONX NY
10473-1868
US

V. Phone/Fax

Practice location:
  • Phone: 718-536-5641
  • Fax:
Mailing address:
  • Phone: 718-536-5641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number081507-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: