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NPI Code Detail

MEDICARE: MR. LUIZ ALBERTO LEIVA LMSW

MEDICARE: MR. LUIZ ALBERTO LEIVA LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
2104100000XSocial WorkerNY

General Provider Information

NPI Number : 1578907036
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LUIZ ALBERTO LEIVA LMSW
Provider Business Mailing Address
First Line : 1225 GERARD AVE
Second Line :
City : BRONX
State : NY
Zip : 10452-8015
Country : US
Telephone Number : 718-960-2624
Fax Number :
Provider Business Practice Location Address
First Line : 1225 GERARD AVE
Second Line :
City : BRONX
State : NY
Zip : 10452-8015
Country : US
Telephone Number : 718-960-2624
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2013
Last Update Date : 11/28/2022

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