Luis Edgardo Fontanez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

042654 Issued in NY

Practice address

3424 Kossuth Avenue
North Central Bronx Hospital
Bronx, NY 10467

Phone

(718) 519-3345

Fax

(718) 519-4892

NPI assigned

Jan 30, 2007

Last updated

Jul 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Luis Edgardo Fontanez Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1396881934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 BOSTON RD APT 4B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104679042",
            "telephone_number": "646-667-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVENUE",
            "address_2": "NORTH CENTRAL BRONX HOSPITAL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-519-3345",
            "fax_number": "718-519-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANEZ",
        "first_name": "LUIS",
        "middle_name": "EDGARDO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "042654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE #",
            "identifier": "042654",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUIS",
            "last_name": "FONTANEZ",
            "middle_name": "EDGARDO",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Destiny Font
• Camille Fontaine, M.D.
• Samantha Jean Fontana I
• Eulalio Fontanez
• Ferdinand Fontanez
• Obdulia B Fontanez, LMSW
• Raquel Marie Fontanez, DMD
• Lynda Marie Fonte
• Krista J Fontenelle-Garcia Batiz
• Jhollie Fontimayor

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.