Provider Demographics
NPI:1245316926
Name:IGLESIAS, RICARDO HORACIO (MSW)
Entity type:Individual
Prefix:MRS
First Name:RICARDO
Middle Name:HORACIO
Last Name:IGLESIAS
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 1:175 W 93RD ST APT 17D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-9346
Mailing Address - Country:US
Mailing Address - Phone:212-932-2925
Mailing Address - Fax:
Practice Address - Street 1:175 W 93RD ST APT 17D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-9346
Practice Address - Country:US
Practice Address - Phone:212-932-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000552-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health