Individual
CARLOS S LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8804 COMMONWEALTH BLVD, BELLEROSE, NY 11426-1639
(914) 939-8935
(718) 312-0730
Mailing address
8804 COMMONWEALTH BLVD, BELLEROSE, NY 11426-1639
(914) 939-8935
(718) 312-0730
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
72081083
NY
Other
Enumeration date
07/15/2013
Last updated
07/15/2013
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