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General NPI Number Information
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NPI Number | 1497157838
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Entity Type | Organization
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Legal Business Name | JOSE J VASQUEZ CSW P.C.
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 1285 ROUTE 9 STE 7B
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-4993
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Country | US
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Telephone | 845-632-2939
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Fax | 845-632-2940
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Provider Business Mailing Address
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Address Line | 1285 ROUTE 9 STE 7B
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-4993
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Country | US
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Telephone | 845-632-2939
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Fax | 845-632-2940
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Authorized Official
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Title or Position | LCSW
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Name | MR. JOSE J VAZQUEZ
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Credential | LCSW
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Telephone | 845-632-2939
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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 | R037723-1
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License Number State | NY
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