Medina, Chanill

Medina, Chanill is an sole proprietor health care provider with primary practice located at 121 Cedar Ln Ste 102 , Teaneck NJ 07666-4457. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Medina, Chanill can be contacted via phone (201) 357-9885.

Contact Information

Primary practice address
121 Cedar Ln Ste 102 Teaneck NJ 07666-4457
Phone: (201) 357-9885
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 37FI00255300 New Jersey
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 002774 New York

Profile Details

NPI number 1104414895
LBN Legal business name Medina, Chanill
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 7th, 2021
Last updated Aug 13th, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104414895 NPPES
New Jersey MEDICAID 1230891

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