MEDICARE: BENITA PAREDES SE/TSHH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1023266277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENITA PAREDES SE/TSHH

Provider Business Mailing Address
First Line	:	3130 IRWIN AVE APT 7D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3828
Country	:	US
Telephone Number	:	646-423-3288
Fax Number	:

Provider Business Practice Location Address
First Line	:	3130 IRWIN AVE APT 7D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3828
Country	:	US
Telephone Number	:	646-423-3288
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	09/10/2008

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Directions to “ BENITA PAREDES SE/TSHH” Practice Location

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