Individual
MR. RAUL IZQUIERDO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1509 CORTELYOU RD, BROOKLYN, NY 11226-5607
(718) 940-1212
(718) 462-4098
Mailing address
1509 CORTELYOU RD, BROOKLYN, NY 11226-5607
(718) 940-1212
(718) 462-4098
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
47-2871756
NY
Other
Enumeration date
08/20/2016
Last updated
08/20/2016
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