Provider Demographics
NPI:1841350782
Name:VERA, CESAR R (LCSW)
Entity type:Individual
Prefix:MR
First Name:CESAR
Middle Name:R
Last Name:VERA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 47 HOOVER AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2139
Mailing Address - Country:US
Mailing Address - Phone:718-523-3927
Mailing Address - Fax:
Practice Address - Street 1:OCNI 37 64 72ND ST
Practice Address - Street 2:
Practice Address - City:JACKSON HTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6143
Practice Address - Country:US
Practice Address - Phone:718-335-3434
Practice Address - Fax:718-335-4731
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR02554611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01932LMedicare ID - Type Unspecified