Provider Demographics
NPI:1942042452
Name:VALDEZ ENCARNACION, TEUSIS RAQUEL
Entity type:Individual
Prefix:
First Name:TEUSIS
Middle Name:RAQUEL
Last Name:VALDEZ ENCARNACION
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 1:941 SIMPSON ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-3328
Mailing Address - Country:US
Mailing Address - Phone:917-535-0281
Mailing Address - Fax:
Practice Address - Street 1:941 SIMPSON ST APT 3C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-3328
Practice Address - Country:US
Practice Address - Phone:917-535-0281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator