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NPI 1215832472

NPI 1215832472 : MIRIAM MOTECHIN : POMONA, NY

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General NPI Number Information
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    NPI Number           |    1215832472
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    Entity Type          |    Individual 
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    Provider Name        |    MIRIAM MOTECHIN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/08/2026
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    Last Update Date     |    10/08/2026
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Provider Practice Location Address
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    Address Line         |    6 MEDICAL PARK DR 
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    City                 |    POMONA
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    State                |    NY
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    Zip                  |    10970-3525
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    Country              |    US
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    Telephone            |    845-425-5252
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    41 HIGHGATE TER 
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    City                 |    BERGENFIELD
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    State                |    NJ
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    Zip                  |    07621-3919
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    Country              |    US
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    Telephone            |    201-370-8353
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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        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    028111
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    License Number State |    NY
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