Most Relevant Information
Provider Data
| NPI Number: | 1003458043 |
| Provider Name: | ADRIANA MEDINA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/10/2019 |
| Last Updated: | 10/10/2019 |
Provider Practice Location
225 BROADHOLLOW RD STE 402
MELVILLE
NY
117474899
Practice Location Phone/Fax
| Phone: | 6313857795 |
| Fax: | 6313857795 |
Provider Mailing Location
52 DOSORIS LN
GLEN COVE
NY
115421541
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |