Healthcare Provider Details

I. General information

NPI: 1083377543
Provider Name (Legal Business Name): ROSERYS MARIA SALAZAR NUNEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2021
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2857 LINDEN BLVD
BROOKLYN NY
11208-5126
US

IV. Provider business mailing address

59 STANWIX ST FL 2
BROOKLYN NY
11206-5280
US

V. Phone/Fax

Practice location:
  • Phone: 718-235-3100
  • Fax:
Mailing address:
  • Phone: 917-302-4184
  • 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: