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NPI Code Detail

MEDICARE: MS. XIOMARA AYALA LCSW

MEDICARE: MS. XIOMARA AYALA LCSW
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
11041C0700XClinical Social Worker078197NY

General Provider Information

NPI Number : 1750613642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. XIOMARA AYALA LCSW
Provider Business Mailing Address
First Line : 2040 WHITE PLAINS RD # 1155
Second Line :
City : BRONX
State : NY
Zip : 10462-1464
Country : US
Telephone Number : 917-652-6563
Fax Number :
Provider Business Practice Location Address
First Line : 397 BRIDGE ST FL 7
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5247
Country : US
Telephone Number : 917-652-6563
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2010
Last Update Date : 12/20/2023

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