Individual
KAHLIL CINQUE DUPERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-6215
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-6215
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
025829
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2021
Last updated
05/01/2025
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