Individual
RACQUEL FENTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2928 WEST 36TH ST, JBFCS, BROOKLYN, NY 11224
(718) 372-3300
(718) 996-8758
Mailing address
2928 WEST 36TH ST, JBFCS, BROOKLYN, NY 11224
(718) 372-3300
(718) 996-8758
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1225144983
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00057385
—
NY
Enumeration date
02/16/2012
Last updated
02/16/2012
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