Provider Demographics
NPI:1508526682
Name:QUIROGA, JENNY SHABEL
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:SHABEL
Last Name:QUIROGA
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 1:917 124TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1823
Mailing Address - Country:US
Mailing Address - Phone:929-385-9503
Mailing Address - Fax:
Practice Address - Street 1:59 COLONY LN
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2218
Practice Address - Country:US
Practice Address - Phone:516-621-1281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator