Provider Demographics
NPI:1346061165
Name:QUIJANO, MARIA LOURDES
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LOURDES
Last Name:QUIJANO
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:ROCKLAND CHILDREN'S PSYCHIATRIC CENTER
Mailing Address - Street 2:2 FIRST AVENUE
Mailing Address - City:ROCKLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10962
Mailing Address - Country:US
Mailing Address - Phone:845-680-4050
Mailing Address - Fax:
Practice Address - Street 1:ROCKLAND CHILDREN'S PSYCHIATRIC CENTER
Practice Address - Street 2:2 FIRST AVENUE
Practice Address - City:ROCKLAND
Practice Address - State:NY
Practice Address - Zip Code:10962
Practice Address - Country:US
Practice Address - Phone:845-680-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY822277163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent