Individual
ELIZABETH CATHERINE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC MSN RN
Contact information
Practice address
1797 DUTCH BROADWAY, CLINIC #2061, ELMONT, NY 11003-4243
(516) 561-1340
Mailing address
1797 DUTCH BROADWAY # 2061, ELMONT, NY 11003-4243
(516) 561-1340
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
679425
NY
363LF0000X
Family Nurse Practitioner
Primary
F346807-01
NY
Other
Enumeration date
11/18/2019
Last updated
12/06/2021
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