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General NPI Number Information
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NPI Number | 1023220639
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Entity Type | Individual
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Provider Name | MR. OSWALDO M. JIMENEZ
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11515 SUTPHIN BLVD
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City | JAMAICA
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State | NY
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Zip | 11434-1020
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Country | US
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Telephone | 718-659-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 65 BURCH AVE
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City | AMITYVILLE
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State | NY
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Zip | 11701-2932
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Country | US
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Telephone | 631-789-3508
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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