Organization
SAMARITAN VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA VAZQUEZ CASAC 16784 (SUBSTANCE ABUSE COUNSELOR)
(718) 292-4455
Entity
Organization
Contact information
Practice address
302 E 119TH ST APT 4B, NEW YORK, NY 10035-4213
(212) 828-1656
(718) 292-9228
Mailing address
302 E 119TH ST APT 4B, NEW YORK, NY 10035-4213
(212) 828-1656
(718) 292-9228
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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