Individual
MRS. ELENA VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
3509 109TH ST, APT. 2R, CORONA, NY 11368-1211
(917) 213-1504
Mailing address
3509 109TH ST, APT. 2R, CORONA, NY 11368-1211
(917) 213-1504
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
007902-1
NY
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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