Basic Information
| Provider Information | |||||||||
| NPI: | 1053601468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MALDONADO | ||||||||
| FirstName: | YAJAIRA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 890 E 6TH ST | ||||||||
| Address2: | APT. 2E | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100097134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3475814736 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2604 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104541199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123668007 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2011 | ||||||||
| LastUpdateDate: | 04/19/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 082180-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.