Individual
DR. IGNACIO MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 PELHAM PKWY S, BUILDING #4 ROOM 4 SOUTH 10, BRONX, NY 10461-1138
(718) 918-3460
(718) 918-7526
Mailing address
1400 PELHAM PKWY S, BUILDING #4 ROOM 4 SOUTH 10, BRONX, NY 10461-1138
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
193912
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01847176
—
NY
Enumeration date
11/06/2006
Last updated
07/08/2007
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