Provider Demographics
NPI:1336299692
Name:MARRERO, LUIS ALBERTO (MSW, CASAC T)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ALBERTO
Last Name:MARRERO
Suffix:
Gender:M
Credentials:MSW, CASAC T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 E 163RD ST
Mailing Address - Street 2:89
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-7220
Mailing Address - Country:US
Mailing Address - Phone:718-993-5721
Mailing Address - Fax:
Practice Address - Street 1:630 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-3107
Practice Address - Country:US
Practice Address - Phone:718-993-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker