| Mih Experience Ltd | |
|
311 Audubon Ave 2nd Floor New York NY 10033-4237 | |
| (212) 256-0725 | |
| (917) 261-4704 |
| Full Name | Mih Experience Ltd |
|---|---|
| Speciality | Counselor |
| Location | 311 Audubon Ave, New York, New York |
| Authorized Official Name and Position | Fernando Taveras (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2122560725 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mih Experience Ltd 311 Audubon Ave 2nd Floor New York NY 10033-4237 Ph: (212) 256-0725 | Mih Experience Ltd 311 Audubon Ave 2nd Floor New York NY 10033-4237 Ph: (212) 256-0725 |
| NPI Number | 1124423520 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 10/28/2014 |
| Medicare PECOS PAC ID | 8527383579 |
|---|---|
| Medicare Enrollment ID | O20150213001370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124423520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Fernando T Taveras |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194769067 PECOS PAC ID: 0547243115 Enrollment ID: I20040628000951 |
| Provider Name | Leonardo Vando |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225007271 PECOS PAC ID: 5597771444 Enrollment ID: I20060301000523 |
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