Provider Demographics
NPI:1386055820
Name:QUERO, KRYSBEL
Entity type:Individual
Prefix:
First Name:KRYSBEL
Middle Name:
Last Name:QUERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 STRONG AVE
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368
Mailing Address - Country:US
Mailing Address - Phone:718-685-8498
Mailing Address - Fax:
Practice Address - Street 1:10201 STRONG AVE
Practice Address - Street 2:FLOOR 3
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3249
Practice Address - Country:US
Practice Address - Phone:718-685-8498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03505424Medicaid