Provider Demographics
NPI:1851806962
Name:HECHAVARRIA, GLADYS RAFAELA
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:RAFAELA
Last Name:HECHAVARRIA
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 1:70 PARK TER W APT E13
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1346
Mailing Address - Country:US
Mailing Address - Phone:212-361-9034
Mailing Address - Fax:
Practice Address - Street 1:70 PARK TER W APT E13
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1346
Practice Address - Country:US
Practice Address - Phone:212-544-9291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist