Provider Demographics
NPI:1467064808
Name:HUERTA NAVA, SULEYMA
Entity Type:Individual
Prefix:
First Name:SULEYMA
Middle Name:
Last Name:HUERTA NAVA
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 1:789 E 166TH ST APT WB
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-5657
Mailing Address - Country:US
Mailing Address - Phone:347-859-5181
Mailing Address - Fax:
Practice Address - Street 1:789 E 166TH ST APT WB
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-5657
Practice Address - Country:US
Practice Address - Phone:347-859-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
141397918OtherASTORS ID