Healthcare Provider Details

I. General information

NPI: 1821585019
Provider Name (Legal Business Name): CINDY MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 E HOUSTON ST
NEW YORK NY
10002-1122
US

IV. Provider business mailing address

442 E HOUSTON ST
NEW YORK NY
10002-1122
US

V. Phone/Fax

Practice location:
  • Phone: 212-677-5710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: