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General NPI Number Information
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NPI Number | 1346394608
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Entity Type | Individual
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Provider Name | PEDRO VAZQUEZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 401 E 147TH STREET NEW BEGINNINGS COMMUNITY COUNSELING CENTER
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City | BRONX
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State | NY
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Zip | 10455
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Country | US
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Telephone | 718-402-5244
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Fax | 718-665-2456
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Provider Business Mailing Address
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Address Line | 126 A MAGNOLIA AVENUE
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City | JERSEY CITY
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State | NJ
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Zip | 07306
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Country | US
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Telephone | 201-653-8027
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R0501311
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License Number State | NY
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