SearchNew YorkEarly Intervention Provider Agency

Jack Fuentes

NPI 1689556664 · on the registry since 2025 · sole proprietor

Practice

Address
12 Lochness Ln Ph
New City, NY 10956
Phone
(917) 645-8998
Organisation at this address
Kasa Jade Acad Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
Early Intervention Provider Agency
252Y00000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-07-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York