Individual
MA. CHARIDEL DE LA FUENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PMH-BC
Contact information
Practice address
7403 COMMONWEALTH BLVD, BELLEROSE, NY 11426-1839
(718) 264-4805
Mailing address
7403 COMMONWEALTH BLVD, BELLEROSE, NY 11426-1839
(718) 264-4805
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
809321
NY
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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