Healthcare Provider Details

I. General information

NPI: 1679269369
Provider Name (Legal Business Name): BETTINA THERESE MACARIOLA ESCOLANO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 10/16/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 LENOX AVENUE, HARLEM HOSPITAL CENTER RM. 13-106, MLK, DEPARTMENT OF MEDICINE/RESIDENCY PROGR
NEW YORK NY
10037
US

IV. Provider business mailing address

506 LENOX AVENUE, HARLEM HOSPITAL CENTER RM. 13-106, MLK, DEPARTMENT OF MEDICINE/RESIDENCY PROGR
NEW YORK NY
10037
US

V. Phone/Fax

Practice location:
  • Phone: 212-939-1406
  • Fax: 212-939-1462
Mailing address:
  • Phone: 212-939-1406
  • Fax: 212-939-1462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: