Doctor Name: | MR. RUBEN JAY QUINONES |
NPI Number: | 1043591944 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CASAC |
License Number: | 20859 |
Business Practice Address: | 209 Park St Malone, NY - 129531228 |
Business Phone Number: | 5184838980 |
Business Fax Number: | 5184834830 |
Mailing Address: | 209 Park St, MALONE |
State: | NY |
Postal Code: | 129531228 |
Phone Number: | 5184838980 |
Fax Number: | 5184834830 |
NPI Enumeration Date: | 09/06/2011 |
NPI Last Update Date: | 09/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 20859 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |