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Organization
MIH EXPERIENCE LTD
Active
Organization
MIH EXPERIENCE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO TAVERAS MD (OWNER/PHYSICIAN)
(212) 256-0725
Entity
Organization
Contact information
Practice address
311 AUDUBON AVE, 2ND FLOOR, NEW YORK, NY 10033-4237
(212) 256-0725
(917) 261-4704
Mailing address
311 AUDUBON AVE, 2ND FLOOR, NEW YORK, NY 10033-4237
(212) 256-0725
(917) 261-4704
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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