Elijah Roberto Tavarez

NPI #1326652934 in South Ozone Park, New York

Provider Information

NPI Number: 1326652934
Entity Type: Individual
Name: Elijah Roberto Tavarez
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Sep 1, 2020
Last Updated: Sep 1, 2020

Practice Location

Address: 10810 ROCKAWAY BLVD
City: South Ozone Park
State: New York
ZIP Code: 11420
Phone: (718) 845-2620

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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