Basic Information
| Provider Information | |||||||||
| NPI: | 1710334032 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PUERTO RICAN FAMILY INSTITUTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28 DEBEVOISE ST | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112064102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189634430 | ||||||||
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| Practice Location | |||||||||
| Address1: | 28 DEBEVOISE STREET | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189634430 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2016 | ||||||||
| LastUpdateDate: | 05/17/2016 | ||||||||
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| AuthorizedOfficialLastName: | CHAVEZ | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7189634430 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | P01491 | NY | Y | Agencies | Community/Behavioral Health |
No ID Information.