Healthcare Provider Details

I. General information

NPI: 1912549064
Provider Name (Legal Business Name): ARLLEEN MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 ADAM CLAYTON POWELL JR BLVD
NEW YORK NY
10027-4990
US

IV. Provider business mailing address

590 AVENUE OF THE AMERICAS
NEW YORK NY
10011-2022
US

V. Phone/Fax

Practice location:
  • Phone: 212-633-9300
  • Fax:
Mailing address:
  • Phone: 212-633-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number113362-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: