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General NPI Number Information
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NPI Number | 1992457303
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Entity Type | Individual
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Provider Name | ROGER ORLANDO QUINTERO MS
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Gender | Male
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Dates
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Enumeration Date | 01/26/2022
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | FAMILY OF KIDZ 2341 NEW HYDE PARK RD.
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City | NEW HYDE PARK
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State | NY
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Zip | 11040
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Country | US
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Telephone | 516-806-5716
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Fax |
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Provider Business Mailing Address
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Address Line | 11 W LAKELAND ST
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City | BAY SHORE
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State | NY
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Zip | 11706-2621
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Country | US
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Telephone | 631-889-5185
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-55833
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License Number State | NY
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