Provider Demographics
NPI:1962669333
Name:PICHARDO, RANCIEL (MSW)
Entity Type:Individual
Prefix:
First Name:RANCIEL
Middle Name:
Last Name:PICHARDO
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 1:759 E 138TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-1916
Mailing Address - Country:US
Mailing Address - Phone:718-292-8573
Mailing Address - Fax:718-292-8780
Practice Address - Street 1:759 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1916
Practice Address - Country:US
Practice Address - Phone:718-292-8573
Practice Address - Fax:718-292-8780
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker