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NPI Code Detail

MEDICARE: MISS MABEL VASQUEZ

MEDICARE: MISS MABEL VASQUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist

General Provider Information

NPI Number : 1194081216
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MABEL VASQUEZ
Provider Business Mailing Address
First Line : 29 WALNUT DR
Second Line :
City : MAHOPAC
State : NY
Zip : 10541-1265
Country : US
Telephone Number : 646-228-0706
Fax Number :
Provider Business Practice Location Address
First Line : 7000 AUSTIN ST STE 200
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4739
Country : US
Telephone Number : 718-762-7633
Fax Number : 718-886-8694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2012
Last Update Date : 09/18/2018

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Directions to “ MISS MABEL VASQUEZ ” Practice Location

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