Provider Demographics
NPI:1376806703
Name:LUZENTALES, CAROLE PEYRA (MS ED/SPED)
Entity Type:Individual
Prefix:MISS
First Name:CAROLE
Middle Name:PEYRA
Last Name:LUZENTALES
Suffix:
Gender:F
Credentials:MS ED/SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6956 CALDWELL AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2636
Mailing Address - Country:US
Mailing Address - Phone:347-285-5789
Mailing Address - Fax:
Practice Address - Street 1:37-11 35TH AVENUE
Practice Address - Street 2:3C AND 3G
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11101
Practice Address - Country:US
Practice Address - Phone:718-706-7500
Practice Address - Fax:718-706-9595
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1920812174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist