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NPI Code Detail

MEDICARE: DALIA TEEN

MEDICARE:   DALIA  TEEN
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
1104100000XSocial WorkerNY

General Provider Information

NPI Number : 1619402138
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALIA TEEN
Provider Business Mailing Address
First Line : 10525 67TH RD
Second Line : APT 3H
City : FOREST HILLS
State : NY
Zip : 11375-2354
Country : US
Telephone Number : 917-710-8288
Fax Number :
Provider Business Practice Location Address
First Line : 10525 67TH RD
Second Line : APT 3H
City : FOREST HILLS
State : NY
Zip : 11375-2354
Country : US
Telephone Number : 917-710-8288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2017
Last Update Date : 04/21/2017

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Directions to “ DALIA TEEN ” Practice Location

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