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General NPI Number Information
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NPI Number | 1144510751
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Entity Type | Individual
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Provider Name | KENNETH QUIJANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2011
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Last Update Date | 09/08/2011
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Provider Practice Location Address
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Address Line | 108 ALDEN ST
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City | CRANFORD
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State | NJ
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Zip | 07016-2131
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Country | US
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Telephone | 908-497-3925
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Fax | 908-497-3989
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Provider Business Mailing Address
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Address Line | 225 N 16TH ST
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City | KENILWORTH
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State | NJ
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Zip | 07033-1243
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Country | US
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Telephone | 908-497-3925
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Fax | 908-497-3989
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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