Provider Demographics
NPI:1477692044
Name:CABAN VALE, JOHNNY (MSW)
Entity Type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:
Last Name:CABAN VALE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-6222
Mailing Address - Country:US
Mailing Address - Phone:212-924-6320
Mailing Address - Fax:
Practice Address - Street 1:4123 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6222
Practice Address - Country:US
Practice Address - Phone:718-299-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker