Provider Demographics
NPI:1801116256
Name:QUINONES, ELBA M (PSYD)
Entity type:Individual
Prefix:DR
First Name:ELBA
Middle Name:M
Last Name:QUINONES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CROSSHILL ST
Mailing Address - Street 2:STATEN ISLAND
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3307
Mailing Address - Country:US
Mailing Address - Phone:718-448-0771
Mailing Address - Fax:718-448-0771
Practice Address - Street 1:420 95TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7404
Practice Address - Country:US
Practice Address - Phone:718-448-0771
Practice Address - Fax:718-448-0771
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018438-1103T00000X
NY059167-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker