Provider Demographics
NPI:1255508362
Name:LULJGURAY, DELORES (SW)
Entity Type:Individual
Prefix:
First Name:DELORES
Middle Name:
Last Name:LULJGURAY
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 PARK AVE S
Mailing Address - Street 2:STE 302
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7304
Mailing Address - Country:US
Mailing Address - Phone:212-677-8550
Mailing Address - Fax:212-677-5825
Practice Address - Street 1:257 PARK AVE S
Practice Address - Street 2:STE 302
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7304
Practice Address - Country:US
Practice Address - Phone:212-677-8550
Practice Address - Fax:212-677-5825
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
08311962OtherDATE OF BIRTH