Most Relevant Information
Provider Data
| NPI Number: | 1003384405 |
| Provider Name: | ILIANA PAOLA MEDINA |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/05/2018 |
| Last Updated: | 04/30/2024 |
Provider Practice Location
579 COURTLANDT AVE
BRONX
NY
104515013
Practice Location Phone/Fax
| Phone: | 7184852100 |
| Fax: |
Provider Mailing Location
579 COURTLANDT AVE
BRONX
NY
104515013
Provider Mailing Phone/Fax
| Phone: | 7184852100 |
| Fax: |