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NPI Code Detail

MEDICARE: DANIEL JONATHAN NORIEGA

MEDICARE: DANIEL JONATHAN NORIEGA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor015191NY

General Provider Information

NPI Number : 1417797432
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL JONATHAN NORIEGA
Provider Business Mailing Address
First Line : 22418 DAVENPORT AVE
Second Line :
City : QUEENS VILLAGE
State : NY
Zip : 11428-1463
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 83 WOODBINE ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11221-4944
Country : US
Telephone Number : 646-780-9050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2024
Last Update Date : 10/03/2024

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Directions to “ DANIEL JONATHAN NORIEGA ” Practice Location

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