Medina, Miguel Angel

Medina, Miguel Angel is an individual health care provider with primary practice located at 85 W Burnside Ave , Bronx NY 10453-4015. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Medina, Miguel Angel can be contacted via phone (718) 483-1270.

Contact Information

Primary practice address
85 W Burnside Ave Bronx NY 10453-4015
Phone: (718) 483-1270
Fax: (718) 228-7471
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R064077 New York

Profile Details

NPI number 1497714943
LBN Legal business name Medina, Miguel Angel
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2006
Last updated Aug 19th, 2010 - about 15 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 1497714943 NPPES
New York Other 064077 LICENSE#

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