| Otpccet Llc | |
|
39 Hillside Ter Monroe NY 10950-2534 | |
| (845) 637-2775 | |
| (845) 637-2774 |
| Full Name | Otpccet Llc |
|---|---|
| Speciality | Social Worker |
| Location | 39 Hillside Ter, Monroe, New York |
| Authorized Official Name and Position | Efrain Torres (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3474014712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Otpccet Llc 39 Hillside Ter Monroe NY 10950-2534 Ph: (845) 637-2775 | Otpccet Llc 39 Hillside Ter Monroe NY 10950-2534 Ph: (845) 637-2775 |
| NPI Number | 1437784337 |
|---|---|
| Provider Enumeration Date | 03/11/2020 |
| Last Update Date | 03/11/2020 |
| Certification Date | 03/11/2020 |
| Medicare PECOS PAC ID | 1951710029 |
|---|---|
| Medicare Enrollment ID | O20210503001588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437784337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Efrain Torres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033520374 PECOS PAC ID: 5597096966 Enrollment ID: I20191016001701 |
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