Individual
MRS. CARMEN ENID MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2340 ANDREWS AVE, BRONX, NY 10468-6001
(718) 365-7238
(718) 584-3057
Mailing address
22 RIVERVIEW AVE, ARDSLEY, NY 10502-2317
(914) 693-0149
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
006423-1
NY
Other
Enumeration date
12/13/2010
Last updated
12/13/2010
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