Provider Demographics
NPI:1821035098
Name:ALBORES, JULIA RAQUEL
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:RAQUEL
Last Name:ALBORES
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 1:58 DAHILL ROAD, # 6A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218
Mailing Address - Country:US
Mailing Address - Phone:718-369-0508
Mailing Address - Fax:
Practice Address - Street 1:58 DAHILL RD
Practice Address - Street 2:APT.6A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2262
Practice Address - Country:US
Practice Address - Phone:347-989-3849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070504104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY070504OtherMSW