Provider Demographics
NPI:1740414655
Name:VASQUEZ, NADIUSKA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:NADIUSKA
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:07022-1111
Mailing Address - Country:US
Mailing Address - Phone:917-574-1133
Mailing Address - Fax:
Practice Address - Street 1:722 W 168TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3727
Practice Address - Country:US
Practice Address - Phone:212-305-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076590104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker