Provider Demographics
NPI:1548042591
Name:ALMANZAR, CLARISOL
Entity type:Individual
Prefix:
First Name:CLARISOL
Middle Name:
Last Name:ALMANZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 E 199TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-2635
Mailing Address - Country:US
Mailing Address - Phone:347-879-9541
Mailing Address - Fax:
Practice Address - Street 1:284 E 199TH ST APT 6
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-2635
Practice Address - Country:US
Practice Address - Phone:347-879-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118931104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker