Individual
ILDEFONSO OQUENDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
1623 KINGS HWY, BROOKLYN, NY 11229-1209
(929) 273-7601
Mailing address
1776 CASTLE HILL AVE APT 3I, BRONX, NY 10462-4228
(347) 282-8785
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25833
NY
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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