Individual
DR. CARLOS MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 E 68TH ST # 94, DEPARTMENT OF PEDIATRIC UROLOGY, NEW YORK, NY 10065-4870
(212) 746-5361
(121) 746-8065
Mailing address
525 E 68TH ST # 94, DEPARTMENT OF PEDIATRIC UROLOGY, NEW YORK, NY 10065-4870
(212) 746-5361
(121) 746-8065
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
247542-1
NY
208800000X
Urology Physician
MD429306
PA
2088P0231X
Pediatric Urology Physician
Primary
247542
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
PA
Enumeration date
02/01/2007
Last updated
12/18/2023
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