Individual
DR. JAIRO FUERTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
158 CAMBRIDGE AVE, RM 319, GARDEN CITY, NY 11530-4235
(917) 821-4623
Mailing address
158 CAMBRIDGE AVE, RM 319, GARDEN CITY, NY 11530-4235
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
013736
NY
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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