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NPI Code Detail

MEDICARE: MIGUEL HUMARA PH.D.

MEDICARE: MIGUEL HUMARA PH.D.
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
1103TC0700XClinical Psychologist15419NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578577797
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIGUEL HUMARA PH.D.
Provider Business Mailing Address
First Line : 1142 1ST AVE
Second Line : #11
City : NEW YORK
State : NY
Zip : 10021-7959
Country : US
Telephone Number : 917-476-0670
Fax Number :
Provider Business Practice Location Address
First Line : 910 W END AVE
Second Line : #1C
City : NEW YORK
State : NY
Zip : 10025-3533
Country : US
Telephone Number : 212-851-8100
Fax Number : 212-932-0964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/08/2007

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Directions to “ MIGUEL HUMARA PH.D.” Practice Location

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