Provider Demographics
NPI:1740568286
Name:VRATIMOS, PETER (MA, MSW)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:VRATIMOS
Suffix:
Gender:M
Credentials:MA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 B FORT TOTTEN
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11364
Mailing Address - Country:US
Mailing Address - Phone:718-352-2140
Mailing Address - Fax:
Practice Address - Street 1:413 B FORT TOTTEN
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11364
Practice Address - Country:US
Practice Address - Phone:718-352-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker