MEDICARE: MARANYELIN QUEZADA

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
1	222Q00000X	Developmental Therapist	1166051171	NY
2	103K00000X	Behavior Analyst	1-23-68446	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982123352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARANYELIN QUEZADA

Provider Business Mailing Address
First Line	:	950 MOUNT BENEVOLENCE RD
Second Line	:
City	:	NEWTON
State	:	NJ
Zip	:	07860-4321
Country	:	US
Telephone Number	:	646-384-1762
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 ENTERPRISE DRIVE, SUITE 301
Second Line	:
City	:	ROCKAWAY
State	:	NJ
Zip	:	07866-2129
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2017
Last Update Date	:	10/07/2025

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Directions to “ MARANYELIN QUEZADA ” Practice Location

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