Individual
JOHANNA BEATRIZ MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 COMMUNITY DR, MANHASSET, NY 11030-3815
(516) 472-5800
(516) 472-5805
Mailing address
1243 BRETTON RD, VALLEY STREAM, NY 11580-1421
(718) 551-6297
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
349364
NY
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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