Fenol Christopher Larock II
Peer Specialist in Valley Stream, NY. Individual provider (NPI-1).
NPI number1326878596
StatusActive
Last updated in NPPESAug 3, 2024
Details
- NPI
- 1326878596
- Entity type
- Individual (NPI-1)
- Name
- Fenol Christopher Larock II
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 3, 2024
- Certification date
- Aug 3, 2024
- Last updated
- Aug 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | 104100000X | NY | Yes |
Practice location
497 Rockaway AveValley Stream, NY 11581-1909
Phone 718-845-2621 · Fax 718-845-2622
Mailing address
517 Kirkby RdElmont, NY 11003-3523
Phone 516-853-1609
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All 17 Peer Specialist providers in Valley Stream · All 2,560 providers in Valley Stream
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