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NPI Code Detail

MEDICARE: EDINA STELLA

MEDICARE:   EDINA  STELLA
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
11041C0700XClinical Social Worker103129-1NY
2253J00000XFoster Care Agency103129-1NY
3104100000XSocial Worker03129-1NY

General Provider Information

NPI Number : 1528541646
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDINA STELLA
Provider Business Mailing Address
First Line : 2329 ESPLANADE AVE
Second Line :
City : BRONX
State : NY
Zip : 10469-5407
Country : US
Telephone Number : 570-815-9423
Fax Number :
Provider Business Practice Location Address
First Line : 2329 ESPLANADE AVE
Second Line :
City : BRONX
State : NY
Zip : 10469-5407
Country : US
Telephone Number : 570-815-9423
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2018
Last Update Date : 09/13/2018

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Directions to “ EDINA STELLA ” Practice Location

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