Individual
MR. RAYMOND TAVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REPAIR TECHNICIAN
Contact information
Practice address
18 EVERETT ST, VALLEY STREAM, NY 11580-2221
(631) 704-6212
Mailing address
18 EVERETT ST, VALLEY STREAM, NY 11580-2221
(631) 704-6212
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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