Healthcare Provider Details

I. General information

NPI: 1740602630
Provider Name (Legal Business Name): ALBA URENA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 CHRISTOPHER ST
NEW YORK NY
10014-3518
US

IV. Provider business mailing address

27 CHRISTOPHER ST
NEW YORK NY
10014-3518
US

V. Phone/Fax

Practice location:
  • Phone: 212-660-1354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1127249
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: