| Organization Name: | CENTRAL NEW YORK QUEST, INC. |
| NPI Number: | 1649540063 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDY LOPEZ-WILLIAMS (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 587 Main St Suite 108 New York Mills |
| State: | NY US |
| Postal Code: | 134171481 |
| Phone Number: | 3157323431 |
| Fax Number: | 8668222343 |
| NPI Enumeration Date: | 01/02/2012 |
| NPI Last Update Date: | 01/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 017312-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |