(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003552522
Provider Name: JACQUELINE MEDINA
Entity Type: Individual
Taxonomy Code: 101YM0800X
Specialty: Counselor
License Number:
Most Important Dates
Enumeration Date: 05/08/2022
Last Updated: 05/08/2022
Provider Practice Location
160 W 86TH ST
NEW YORK
NY
100244018
Practice Location Phone/Fax
Phone: 2128751300
Fax:
Provider Mailing Location
5272 72ND ST FL 1
MASPETH
NY
113781436
Provider Mailing Phone/Fax
Phone: 3472955181
Fax: