Provider Demographics
NPI:1932818796
Name:PACHECO BORRERO, MARISOL (MSW)
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:PACHECO BORRERO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 DUNCAN ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3706
Mailing Address - Country:US
Mailing Address - Phone:917-664-0285
Mailing Address - Fax:
Practice Address - Street 1:1006 DUNCAN ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3706
Practice Address - Country:US
Practice Address - Phone:917-664-0285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty