Individual
OMAR JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 542-8770
Mailing address
1576 TAYLOR AVE APT 4K, BRONX, NY 10460-3363
(347) 765-4941
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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