Healthcare Provider Details

I. General information

NPI: 1801100011
Provider Name (Legal Business Name): NORTON AURTHUR SAENZ DE VITERI LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 03/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10340 52ND AVE
CORONA NY
11368-3253
US

IV. Provider business mailing address

10340 52ND AVE
CORONA NY
11368-3253
US

V. Phone/Fax

Practice location:
  • Phone: 646-709-1841
  • Fax:
Mailing address:
  • Phone: 646-709-1841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number083840
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: