Individual
DANA TYLER MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3201 KINGS HWY, BROOKLYN, NY 11234-2625
(718) 757-5940
Mailing address
8137 165TH ST, JAMAICA, NY 11432-1209
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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