MEDICARE: CARLINA E LAHOZ-OGANDO

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	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1407391402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLINA E LAHOZ-OGANDO

Provider Business Mailing Address
First Line	:	329 E 149TH ST FL 4
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5626
Country	:	US
Telephone Number	:	718-769-2698
Fax Number	:

Provider Business Practice Location Address
First Line	:	2820 BAILEY AVE APT 19D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463
Country	:	US
Telephone Number	:	347-356-8047
Fax Number	:

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

Provider Enumeration Date	:	12/29/2016
Last Update Date	:	02/13/2020

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