Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 085949 | NY |
NPI | 1003163502 |
---|---|
Provider Name | Georgette Pastor |
First Address | Saint Albans, NY 11412-3819 |
Second Address | Jamaica, NY 11432-4919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2012 |
Last Update Date | 14/08/2012 |