Provider Demographics
NPI:1982707899
Name:ALMANZAR, JUAN J (LCSW)
Entity type:Individual
Prefix:MR
First Name:JUAN
Middle Name:J
Last Name:ALMANZAR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:JUAN
Other - Middle Name:J
Other - Last Name:ALMANZAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:321 79TH ST APT 30
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5656
Mailing Address - Country:US
Mailing Address - Phone:917-364-0303
Mailing Address - Fax:
Practice Address - Street 1:39 W. 31 ST
Practice Address - Street 2:GREELEY SQUARE STATION
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10001-9994
Practice Address - Country:US
Practice Address - Phone:917-364-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073578-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker