Provider Demographics
NPI:1427362565
Name:PASTRAS, PETER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:PASTRAS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PROSPECT ST
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1606
Mailing Address - Country:US
Mailing Address - Phone:201-652-4702
Mailing Address - Fax:201-652-4704
Practice Address - Street 1:6 PROSPECT ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1606
Practice Address - Country:US
Practice Address - Phone:201-652-4702
Practice Address - Fax:201-652-4704
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSW 44SC00758200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker