Provider Demographics
NPI:1326479973
Name:ROSADO ORTIZ, YOLANDA
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:ROSADO ORTIZ
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 1:1020 GRAND CONCOURSE
Mailing Address - Street 2:APT 5N
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2606
Mailing Address - Country:US
Mailing Address - Phone:718-541-3605
Mailing Address - Fax:
Practice Address - Street 1:1020 ANDERSON AVE
Practice Address - Street 2:PRE-K SOCIAL WORKER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-5302
Practice Address - Country:US
Practice Address - Phone:718-541-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057010-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool