Individual
JULIA EMMA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5 GRACE CHURCH ST, PORT CHESTER, NY 10573-4911
(914) 632-2737
Mailing address
PO BOX 552, RIVERSIDE, CT 06878-0552
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6849
CT
Other
Enumeration date
10/02/2024
Last updated
11/20/2024
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