Provider Demographics
NPI:1164670808
Name:ABOITIZ, ANA-ROSA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANA-ROSA
Middle Name:
Last Name:ABOITIZ
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 1:180 RIVERSIDE DRIVE
Mailing Address - Street 2:APARTMENT 8A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1049
Mailing Address - Country:US
Mailing Address - Phone:646-645-3340
Mailing Address - Fax:
Practice Address - Street 1:255 W. 88TH STREET
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1717
Practice Address - Country:US
Practice Address - Phone:646-645-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-06
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY0813231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
13786392OtherCAQH