Healthcare Provider Details

I. General information

NPI: 1912246075
Provider Name (Legal Business Name): GREGORY OCASIO L.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2013
Last Update Date: 02/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 CALLE SAN CLAUDIO STE. 206 CUPEY PROFESSIONAL MALL
SAN JUAN PR
00926-9907
US

IV. Provider business mailing address

359 CALLE SAN CLAUDIO STE. 206 CUPEY PROFESSIONAL MALL
SAN JUAN PR
00926-9907
US

V. Phone/Fax

Practice location:
  • Phone: 787-310-8880
  • Fax:
Mailing address:
  • Phone: 787-310-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2981
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: