Individual
CLEIDYS TAVERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
156 W 174TH ST, APT 4B, BRONX, NY 10453-7507
(347) 701-4816
Mailing address
156 W 174TH ST, APT 4B, BRONX, NY 10453-7507
(347) 701-4816
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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