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General NPI Number Information
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NPI Number | 1558425538
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Entity Type | Individual
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Provider Name | DAVID MOLINA M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 401 E 147TH ST
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City | BRONX
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State | NY
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Zip | 10455-4103
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Country | US
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Telephone | 718-402-5244
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Fax | 718-665-1174
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Provider Business Mailing Address
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Address Line | 2736 PATRICIA LN
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City | BELLMORE
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State | NY
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Zip | 11710-5208
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Country | US
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Telephone | 516-225-8266
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Fax | 718-829-3668
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 186627
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License Number State | NY
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