Provider Demographics
NPI:1992923841
Name:ARELLANO & BERRIO, LLC
Entity type:Organization
Organization Name:ARELLANO & BERRIO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:ARELLANO
Authorized Official - Suffix:SR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-610-9466
Mailing Address - Street 1:615 PAVONIA AVE
Mailing Address - Street 2:# 1
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2923
Mailing Address - Country:US
Mailing Address - Phone:201-610-9466
Mailing Address - Fax:201-610-0801
Practice Address - Street 1:615 PAVONIA AVE
Practice Address - Street 2:# 1
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2923
Practice Address - Country:US
Practice Address - Phone:201-610-9466
Practice Address - Fax:201-610-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045977001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ005474Medicare ID - Type Unspecified