Individual
IRISNEIDA A SUERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12125 8TH AVE, COLLEGE POINT, NY 11356-1156
(917) 600-8102
Mailing address
12125 8TH AVE, COLLEGE POINT, NY 11356-1156
(917) 600-8102
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
174400000X
Specialist
812175
NY
Other
Enumeration date
04/01/2024
Last updated
12/20/2024
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