Provider Demographics
NPI:1841540135
Name:URENA, JOSELIN MERCEDES (MASTER DEGREE)
Entity type:Individual
Prefix:MRS
First Name:JOSELIN
Middle Name:MERCEDES
Last Name:URENA
Suffix:
Gender:F
Credentials:MASTER DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9516 76TH ST
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-1012
Mailing Address - Country:US
Mailing Address - Phone:646-924-5706
Mailing Address - Fax:
Practice Address - Street 1:9516 76TH ST
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-1012
Practice Address - Country:US
Practice Address - Phone:646-924-5706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist