Provider Demographics
NPI:1154752335
Name:ACHECAR, MIGFANGEL
Entity type:Individual
Prefix:
First Name:MIGFANGEL
Middle Name:
Last Name:ACHECAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89-21 ELMHURST AVENUE APT128
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1544
Mailing Address - Country:US
Mailing Address - Phone:718-607-1311
Mailing Address - Fax:
Practice Address - Street 1:8921 ELMHURST AVE APT 128
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1549
Practice Address - Country:US
Practice Address - Phone:718-607-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1905241174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist