Individual
JULISSA ACEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST STE 200, FOREST HILLS, NY 11375-4739
(917) 806-5805
(917) 806-5805
Mailing address
40 LUNN AVE, BERGENFIELD, NJ 07621-2539
(917) 445-0074
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/28/2017
Last updated
07/28/2017
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