Provider Demographics
NPI:1295462463
Name:SUAREZ-PYNDUS, ANDREA G (LSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:G
Last Name:SUAREZ-PYNDUS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-4833
Mailing Address - Country:US
Mailing Address - Phone:201-600-1572
Mailing Address - Fax:
Practice Address - Street 1:165 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-1931
Practice Address - Country:US
Practice Address - Phone:201-600-1572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-06
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06792900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker