Healthcare Provider Details

I. General information

NPI: 1609935683
Provider Name (Legal Business Name): JOVANNA SACHA NIVAR M.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 57TH ST NEWYORK
NEW YORK NY
10019-3320
US

IV. Provider business mailing address

PO BOX 3620222 PACC
NEW YORK NY
10129-0014
US

V. Phone/Fax

Practice location:
  • Phone: 646-239-5519
  • Fax: 212-971-6041
Mailing address:
  • Phone: 646-239-5519
  • Fax: 212-971-6041

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: