Basic Information
| Provider Information | |||||||||
| NPI: | 1437298403 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSORIO | ||||||||
| FirstName: | LUCELIDA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 91-31 QUEENS BLVD SUITE 618 | ||||||||
| Address2: | |||||||||
| City: | ELMHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182750983 | ||||||||
| FaxNumber: | 7182757973 | ||||||||
| Practice Location | |||||||||
| Address1: | 145 WEST 15TH STREET | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129246320 | ||||||||
| FaxNumber: | 2126915635 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 071341-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.