Healthcare Provider Details

I. General information

NPI: 1144765744
Provider Name (Legal Business Name): MARIA ESCALONA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2017
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 AUDUBON AVE
NEW YORK NY
10040-3401
US

IV. Provider business mailing address

60 HAVEN AVE
NEW YORK NY
10032-2604
US

V. Phone/Fax

Practice location:
  • Phone: 646-565-1457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: