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NPI Code Detail

MEDICARE: OFICINA PSIQUIATRICA HISPANA

MEDICARE: OFICINA PSIQUIATRICA HISPANA
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
12084P0800XPsychiatry Physician193940NY

General Provider Information

NPI Number : 1861651010
Entity Type Code : Organization
Provider Name (Legal Business Name) : OFICINA PSIQUIATRICA HISPANA
Provider Business Mailing Address
First Line : 3768 91ST ST
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-7928
Country : US
Telephone Number : 718-899-9300
Fax Number : 718-899-9199
Provider Business Practice Location Address
First Line : 3768 91ST ST
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-7928
Country : US
Telephone Number : 718-899-9300
Fax Number : 718-899-9199
Authorized Official
Title or Position : CEO
Name : DR. XAVIER SAN MIGUEL
Credential : M.D.
Telephone Number : 718-899-9300
Provider Enumeration Date : 06/03/2008
Last Update Date : 06/03/2008

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Directions to “OFICINA PSIQUIATRICA HISPANA ” Practice Location

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