Provider Demographics
NPI:1427805522
Name:POBLANO CUAYA, ANAHI
Entity type:Individual
Prefix:
First Name:ANAHI
Middle Name:
Last Name:POBLANO CUAYA
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 1:16110 JAMAICA AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-6139
Mailing Address - Country:US
Mailing Address - Phone:929-614-1450
Mailing Address - Fax:
Practice Address - Street 1:16110 JAMAICA AVE FL 2
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6139
Practice Address - Country:US
Practice Address - Phone:929-614-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker