Individual
JORGE CUENCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3584 JEROME AVE., BRONX, NY 10467
(718) 653-1537
(518) 882-1426
Mailing address
PO BOX 31094, HARTFORD, CT 06150-1094
(518) 952-8140
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420795
—
NY
Enumeration date
07/29/2008
Last updated
07/29/2008
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