Individual
CARMEN EVELYN JAQUEZ GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 WEBB AVE, BRONX, NY 10468-3922
(347) 337-1277
Mailing address
2500 WEBB AVE, BRONX, NY 10468-3922
(347) 337-1277
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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