Provider Demographics
NPI:1134322795
Name:OQUENDO, OVED (L, RT)
Entity Type:Individual
Prefix:
First Name:OVED
Middle Name:
Last Name:OQUENDO
Suffix:
Gender:M
Credentials:L, RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13618 39TH AVE
Mailing Address - Street 2:SUITE 906
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5516
Mailing Address - Country:US
Mailing Address - Phone:718-961-8817
Mailing Address - Fax:718-961-8815
Practice Address - Street 1:13618 39TH AVE
Practice Address - Street 2:SUITE 906
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5516
Practice Address - Country:US
Practice Address - Phone:718-961-8817
Practice Address - Fax:718-961-8815
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1046672471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography