Individual
TANAIRI H QUEZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
177 FORT WASHINGTON AVE RM 5-124A, NEW YORK, NY 10032-3733
(484) 602-3694
Mailing address
177 FORT WASHINGTON AVE RM 5-124A, NEW YORK, NY 10032-3733
(516) 562-5000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
023065
NY
Other
Enumeration date
12/18/2018
Last updated
07/26/2022
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