Medina, Elizabeth

Medina, Elizabeth is an individual health care provider with primary practice located at 217 Havemeyer St 4Th Floor, Brooklyn NY 11211-6277. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Medina, Elizabeth can be contacted via phone (718) 963-4430.

Contact Information

Primary practice address
217 Havemeyer St 4Th Floor Brooklyn NY 11211-6277
Phone: (718) 963-4430
Fax: (718) 963-0814
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X

Profile Details

NPI number 1487726642
LBN Legal business name Medina, Elizabeth
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487726642 NPPES
New York Other 040426034512 FIDELIS

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