Most Relevant Information
Provider Data
| NPI Number: | 1003213802 |
| Provider Name: | RICHARD VACTOR LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 079647 |
Most Important Dates
| Enumeration Date: | 11/24/2014 |
| Last Updated: | 11/24/2014 |
Provider Practice Location
177 EAST 122ND STREET
NEW YORK
NY
10035
Practice Location Phone/Fax
| Phone: | 2123607116 |
| Fax: | 2123607183 |
Provider Mailing Location
56 MADELEINE AVE
NEW ROCHELLE
NY
108013615
Provider Mailing Phone/Fax
| Phone: | 9143493723 |
| Fax: |