Provider Demographics
NPI:1720430713
Name:BOTERO, GABRIEL JR (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:BOTERO
Suffix:JR
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WHITE PLAINS VET CENTER
Mailing Address - Street 2:300 HAMILTON AVENUE
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601
Mailing Address - Country:US
Mailing Address - Phone:914-682-6250
Mailing Address - Fax:
Practice Address - Street 1:WHITE PLAINS VET CENTER
Practice Address - Street 2:300 HAMILTON AVENUE, 1ST FLOOR, SUITE C
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-682-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical