Provider Demographics
NPI:1184992034
Name:QUEZADA, HECTOR RAMON (RN)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:RAMON
Last Name:QUEZADA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:35 E 176TH ST
Mailing Address - Street 2:APT # 3C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-6210
Mailing Address - Country:US
Mailing Address - Phone:718-993-3397
Mailing Address - Fax:718-993-2460
Practice Address - Street 1:260 E 161ST ST
Practice Address - Street 2:TRACK LEVEL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-3512
Practice Address - Country:US
Practice Address - Phone:718-993-3397
Practice Address - Fax:718-993-2460
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY581171163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)