Healthcare Provider Details

I. General information

NPI: 1871891762
Provider Name (Legal Business Name): CHRISTINE LEIGH FARANDA L.M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2011
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WESTCHESTER SQ
BRONX NY
10461-3513
US

IV. Provider business mailing address

46 SCENIC VW
YORKTOWN HEIGHTS NY
10598-5139
US

V. Phone/Fax

Practice location:
  • Phone: 914-949-6640
  • Fax:
Mailing address:
  • Phone: 914-949-6640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number067523
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: