Individual
RICHARD A MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2976 NORTHERN BLVD FL 2, LONG ISLAND CITY, NY 11101-2829
(212) 691-7554
(347) 510-3457
Mailing address
2976 NORTHERN BLVD FL 2, LONG ISLAND CITY, NY 11101-2829
(212) 691-7554
(347) 510-3457
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPA-1891
NY
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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