Individual
RICHARD MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
9 EUCLID AVE, RIDGEFIELD PARK, NJ 07660-1914
(201) 304-8716
Mailing address
9 EUCLID AVE, RIDGEFIELD PARK, NJ 07660-1914
(201) 304-8716
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00495200
NJ
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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