| Long Island Consultation Center | |
|
9131 Queens Blvd Ste 222 Elmhurst NY 11373-5511 | |
| (718) 896-3400 | |
| Not Available |
| Full Name | Long Island Consultation Center |
|---|---|
| Speciality | Counselor |
| Location | 9131 Queens Blvd Ste 222, Elmhurst, New York |
| Authorized Official Name and Position | Jensyn Marquesano (CLINICIAN) |
| Authorized Official Contact | 9149605756 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Island Consultation Center 19 Faith Ln Ardsley NY 10502-2528 Ph: (914) 960-5756 | Long Island Consultation Center 9131 Queens Blvd Ste 222 Elmhurst NY 11373-5511 Ph: (718) 896-3400 |
| NPI Number | 1356016703 |
|---|---|
| Provider Enumeration Date | 08/09/2021 |
| Last Update Date | 08/09/2021 |
| Certification Date | 07/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356016703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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