Individual
MR. IVAN ALDO MEDRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
8212 151ST AVE, HOWARD BEACH, NY 11414-1793
(718) 848-0300
(718) 835-2862
Mailing address
8212 151ST AVE, HOWARD BEACH, NY 11414-1793
(718) 848-0300
(718) 835-2862
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
0931321
NY
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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