Provider Demographics
NPI:1093578064
Name:CARRASCO, DIONALY
Entity Type:Individual
Prefix:
First Name:DIONALY
Middle Name:
Last Name:CARRASCO
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 1:2825 3RD AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-4073
Mailing Address - Country:US
Mailing Address - Phone:585-709-8319
Mailing Address - Fax:
Practice Address - Street 1:2825 3RD AVE STE 402
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4073
Practice Address - Country:US
Practice Address - Phone:585-709-8319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker