Individual
DAMARIS TAVERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6338 FITCHETT ST, REGO PARK, NY 11374-2812
(407) 242-4638
Mailing address
6338 FITCHETT ST, REGO PARK, NY 11374-2812
(407) 242-4638
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
806687
NY
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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