Provider Demographics
NPI:1316119001
Name:CORA-SANCHEZ, LUCILA
Entity type:Individual
Prefix:
First Name:LUCILA
Middle Name:
Last Name:CORA-SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16822 POWELLS COVE BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1523
Mailing Address - Country:US
Mailing Address - Phone:718-767-1040
Mailing Address - Fax:
Practice Address - Street 1:16822 POWELLS COVE BLVD
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1523
Practice Address - Country:US
Practice Address - Phone:718-767-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071162-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical