Provider Demographics
NPI:1093992430
Name:QUERIJERO, RENEE R (RPH)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:R
Last Name:QUERIJERO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 W 48TH ST APT 207
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1331
Mailing Address - Country:US
Mailing Address - Phone:212-262-3522
Mailing Address - Fax:
Practice Address - Street 1:319 W 48TH ST APT 207
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-1331
Practice Address - Country:US
Practice Address - Phone:212-262-3522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist