Provider Demographics
NPI:1578380952
Name:PROFUMO, AARON LUIS
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:LUIS
Last Name:PROFUMO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 PAVONIA AVE APT 1-10
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1530
Mailing Address - Country:US
Mailing Address - Phone:917-593-5395
Mailing Address - Fax:
Practice Address - Street 1:1 ECHO HILL ROAD
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522
Practice Address - Country:US
Practice Address - Phone:914-693-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool