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General NPI Number Information
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NPI Number | 1174886444
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Entity Type | Individual
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Provider Name | RAQUEL COLLADO-GUERRERO SPECIAL ED TEACHER
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Gender | Female
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 328 E 62ND ST
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City | NEW YORK
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State | NY
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Zip | 10065-8206
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Country | US
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Telephone | 212-752-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 15710 RIVERSIDE DR W APT 4X 4X
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City | NEW YORK
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State | NY
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Zip | 10032-7035
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Country | US
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Telephone | 347-538-1571
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 675325
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License Number State | NY
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