Individual
FERNANDO MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 312-8532
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
(212) 326-8532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
022363
NY
363A00000X
Physician Assistant
Primary
25MP00909600
NJ
Other
Enumeration date
06/07/2018
Last updated
12/09/2025
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