MEDICARE: PATRICIA E MEDINA

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	225700000X	Massage Therapist	032966-01	NY

General Provider Information

NPI Number	:	1093677791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA E MEDINA

Provider Business Mailing Address
First Line	:	667 RIDGE HILL BLVD
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10710-7730
Country	:	US
Telephone Number	:	914-760-6047
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N BROADWAY
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-2466
Country	:	US
Telephone Number	:	914-760-6047
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ PATRICIA E MEDINA ” Practice Location

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