Individual
ELIZABETH MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
217 HAVEMEYER ST, 4TH FLOOR, BROOKLYN, NY 11211-6277
(718) 963-4430
(718) 963-0814
Mailing address
217 HAVEMEYER ST, 4TH FLOOR, BROOKLYN, NY 11211-6277
(718) 963-4430
(718) 963-0814
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040426034512
FIDELIS
NY
Enumeration date
11/14/2006
Last updated
07/08/2007
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