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Individual

MR. CESAR VALENTE GARDUQUE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
54 POLIFLY RD APT 311, HACKENSACK, NJ 07601-3295
(646) 206-1025
(201) 880-0614
Mailing address
54 POLIFLY RD APT 311, HACKENSACK, NJ 07601-3295
(646) 206-1025
(201) 880-0614

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
013016
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
013016
NYSED
NY
01
46TR00447800
NJ STATE LICENSE
NJ
Enumeration date
04/20/2009
Last updated
04/20/2009
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