Active NPI
Obdulia B Fontanez, LMSW
- Clinical Social Worker
- Bronx, NY
National Provider Identifier
1083755532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 070359
- Practice address
- 1621 Eastchester Road
Bronx,, NY 10461 - Phone
- (718) 405-8040
- Fax
- (718) 405-8060
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 070359 | NY | Primary |
Addresses
Primary practice location
1621 Eastchester Road
Bronx,, NY 10461
Mailing address
11 W Gibbons Street
Linden, NJ 07036
Phone (646) 496-6090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070359 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1083755532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 W GIBBONS STREET",
"city": "LINDEN",
"state": "NJ",
"postal_code": "07036",
"telephone_number": "646-496-6090",
"fax_number": "718-405-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 EASTCHESTER ROAD",
"city": "BRONX,",
"state": "NY",
"postal_code": "10461",
"telephone_number": "718-405-8040",
"fax_number": "718-405-8060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTANEZ",
"first_name": "OBDULIA",
"middle_name": "B",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2011-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "070359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.