Provider Demographics
NPI:1740727023
Name:ROBLES, NILDA I (ADV CASAC-G)
Entity type:Individual
Prefix:
First Name:NILDA
Middle Name:
Last Name:ROBLES
Suffix:I
Gender:F
Credentials:ADV CASAC-G
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-6305
Mailing Address - Country:US
Mailing Address - Phone:718-583-5100
Mailing Address - Fax:
Practice Address - Street 1:770 E 176TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4617
Practice Address - Country:US
Practice Address - Phone:718-583-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31252101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)