Provider Demographics
NPI:1265721658
Name:VARGAS, ANA (MA)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 KAPPOCK ST
Mailing Address - Street 2:SUITE 19K
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-6420
Mailing Address - Country:US
Mailing Address - Phone:917-597-3193
Mailing Address - Fax:
Practice Address - Street 1:336 FORT WASHINGTON AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6803
Practice Address - Country:US
Practice Address - Phone:212-923-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY44819101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor