Provider Demographics
NPI:1063673937
Name:BORRERO-PERRY, ANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BORRERO-PERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MADISON AVE
Mailing Address - Street 2:SUITE 610
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0801
Mailing Address - Country:US
Mailing Address - Phone:212-725-3398
Mailing Address - Fax:212-868-3331
Practice Address - Street 1:280 MADISON AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0801
Practice Address - Country:US
Practice Address - Phone:212-725-3398
Practice Address - Fax:212-868-3331
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0240861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3641098OtherOXFORD
NYN8C851Medicare UPIN
N8C851Medicare ID - Type Unspecified