Provider Demographics
NPI:1780390419
Name:PAUL, CLERILIA (CASEMANGER,CARECOORD)
Entity type:Individual
Prefix:
First Name:CLERILIA
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:CASEMANGER,CARECOORD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 LENOX AVENUE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027
Mailing Address - Country:US
Mailing Address - Phone:212-663-3000
Mailing Address - Fax:
Practice Address - Street 1:560 SOUTHERN BLVD.
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455
Practice Address - Country:US
Practice Address - Phone:718-560-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator