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General NPI Number Information
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NPI Number | 1619573599
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Entity Type | Individual
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Provider Name | SANDRA QUEVEDO
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 356 VETERANS MEMORIAL HWY
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City | COMMACK
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State | NY
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Zip | 11725-4343
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Country | US
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Telephone | 516-693-2389
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Fax |
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Provider Business Mailing Address
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Address Line | 356 VETERANS MEMORIAL HWY STE 2
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City | COMMACK
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State | NY
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Zip | 11725-4332
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Country | US
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Telephone | 845-486-2703
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Fax | 516-693-2389
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 109855
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License Number State | NY
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