Provider Demographics
NPI:1467578807
Name:FOJAS, MARIA ELISA MONTES (LICENSED CLINICAL SW)
Entity Type:Individual
Prefix:MS
First Name:MARIA ELISA
Middle Name:MONTES
Last Name:FOJAS
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7812 223RD ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3637
Mailing Address - Country:US
Mailing Address - Phone:718-464-5698
Mailing Address - Fax:
Practice Address - Street 1:8115 164TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1118
Practice Address - Country:US
Practice Address - Phone:718-380-3000
Practice Address - Fax:718-380-9475
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072116-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY072116-1OtherLIC CLINICAL SOCIAL WORK
NY01860KMedicare ID - Type UnspecifiedSOCIAL WORK