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NPI Code Detail

MEDICARE: WENDY MARGARITA MEZA STUDENT

MEDICARE: WENDY MARGARITA MEZA STUDENT
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 Counselor01265601NY

General Provider Information

NPI Number : 1710445945
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY MARGARITA MEZA STUDENT
Provider Business Mailing Address
First Line : 11632 130TH ST
Second Line :
City : SOUTH OZONE PARK
State : NY
Zip : 11420-2604
Country : US
Telephone Number : 917-981-0276
Fax Number :
Provider Business Practice Location Address
First Line : 2857 LINDEN BLVD
Second Line :
City : BROOKLYN
State : NY
Zip : 11208-5126
Country : US
Telephone Number : 718-235-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2019
Last Update Date : 06/07/2026

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Directions to “ WENDY MARGARITA MEZA STUDENT” Practice Location

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