Provider Demographics
NPI:1023632460
Name:JARAMILLO MEDINA, STEPHANY (MD)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:
Last Name:JARAMILLO MEDINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7494
Mailing Address - Country:US
Mailing Address - Phone:212-423-6271
Mailing Address - Fax:
Practice Address - Street 1:260 42ND ST APT 4
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-2883
Practice Address - Country:US
Practice Address - Phone:224-258-7305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD487135207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine