MEDICARE: YANINA THAIS INTRIAGO

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	1041C0700X	Clinical Social Worker	099706	NY

General Provider Information

NPI Number	:	1356209696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANINA THAIS INTRIAGO

Provider Business Mailing Address
First Line	:	2417 3RD AVE STE 701
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-6342
Country	:	US
Telephone Number	:	646-703-9223
Fax Number	:

Provider Business Practice Location Address
First Line	:	2417 3RD AVE STE 701
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-6342
Country	:	US
Telephone Number	:	646-703-9223
Fax Number	:

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

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ YANINA THAIS INTRIAGO ” Practice Location

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