Provider Demographics
NPI:1245408590
Name:AVILES-ZAMORA, VICTORIA A (LCSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:AVILES-ZAMORA
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 1:462 1ST AVE
Mailing Address - Street 2:PEDIATRICS SOCIAL WORK
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-562-1766
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:PEDIATRICS SOCIAL WORK
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3147
Practice Address - Fax:212-562-2610
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080698-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical