Jack Fuentes
Jack Fuentes is an Early Intervention Provider Agency in New City, New York. Practices as a sole proprietor. Licensed in New York.
- Licensed in
- NY
- In the registry since
- 2025
Practice location Address checks out
12 Lochness Ln PhNew City, NY 10956-1515
Phone: (917) 645-8998
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Specialties & licences
| Early Intervention Provider Agency (primary) | Taxonomy 252Y00000X (NY) |
|---|
Record details
| NPI number | 1689556664 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 22, 2025 |
| Last updated in NPPES | July 22, 2025 |
| Certification date | July 22, 2025 |
| Mailing address | 12 Lochness Ln Ph, New City, NY 10956-1515 |
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