MEDICARE: CHRISTINE MINDICINO

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
1	1041C0700X	Clinical Social Worker	0845221	NY

General Provider Information

NPI Number	:	1609305192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MINDICINO

Provider Business Mailing Address
First Line	:	9201 4TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-7065
Country	:	US
Telephone Number	:	718-748-1234
Fax Number	:	718-228-8819

Provider Business Practice Location Address
First Line	:	9201 FOURTH AVENUE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209
Country	:	US
Telephone Number	:	718-748-1234
Fax Number	:	718-228-8819

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	05/26/2026

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Directions to “ CHRISTINE MINDICINO ” Practice Location

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