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General NPI Number Information
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NPI Number | 1073564837
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Entity Type | Individual
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Provider Name | MARIEL BRITO LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 40 FLATBUSH AVENUE EXT # 840
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City | BROOKLYN
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State | NY
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Zip | 11201-1906
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Country | US
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Telephone | 718-439-4338
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Fax | 718-493-4340
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Provider Business Mailing Address
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Address Line | 40 FLATBUSH AVENUE EXT
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City | BROOKLYN
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State | NY
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Zip | 11201-2903
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Country | US
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Telephone | 718-439-4338
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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 | 72071931
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License Number State | NY
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