Provider Demographics
NPI:1083059752
Name:VARGAS, ALBERTO JR (CADC)
Entity Type:Individual
Prefix:MR
First Name:ALBERTO
Middle Name:
Last Name:VARGAS
Suffix:JR
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 GARDEN CT N
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2311
Mailing Address - Country:US
Mailing Address - Phone:201-602-1963
Mailing Address - Fax:
Practice Address - Street 1:595 COUNTY AVE
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2605
Practice Address - Country:US
Practice Address - Phone:201-617-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1000036324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility