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General NPI Number Information
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NPI Number | 1154172286
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Entity Type | Individual
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Provider Name | MADELINE MENSAH
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 11835 QUEENS BLVD STE 400
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City | FOREST HILLS
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State | NY
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Zip | 11375-7211
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Country | US
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Telephone | 917-796-0832
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Fax |
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Provider Business Mailing Address
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Address Line | 13110 244TH ST
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City | JAMAICA
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State | NY
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Zip | 11422-1487
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Country | US
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Telephone | 917-796-0832
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 120935
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License Number State | NY
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