Provider Demographics
NPI:1003829698
Name:FABER, BLANCA VICTORIA (MSW, ACSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BLANCA
Middle Name:VICTORIA
Last Name:FABER
Suffix:
Gender:F
Credentials:MSW, ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W. KINGSBRIDGE RD.
Mailing Address - Street 2:J. J. PETERS VA MEDICAL CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468
Mailing Address - Country:US
Mailing Address - Phone:718-584-9000
Mailing Address - Fax:718-741-4571
Practice Address - Street 1:130 W KINGSBRIDGE RD
Practice Address - Street 2:J. J. PETERS VA MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3904
Practice Address - Country:US
Practice Address - Phone:718-584-9000
Practice Address - Fax:718-741-4571
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY55815331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical