Provider Demographics
NPI:1912269523
Name:MORILLO, MILADYS (MSED)
Entity Type:Individual
Prefix:MS
First Name:MILADYS
Middle Name:
Last Name:MORILLO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 RIVERDALE AVE APT 6A
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-3574
Mailing Address - Country:US
Mailing Address - Phone:646-271-0269
Mailing Address - Fax:914-968-4759
Practice Address - Street 1:501 RIVERDALE AVE APT 6A
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-3574
Practice Address - Country:US
Practice Address - Phone:646-271-0269
Practice Address - Fax:914-968-4759
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-10
Last Update Date:2012-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0429939011174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist