Provider Demographics
NPI:1285139741
Name:MOLINA, JHON ERIC
Entity type:Individual
Prefix:MR
First Name:JHON
Middle Name:ERIC
Last Name:MOLINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 W 78TH ST APT 11C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6708
Mailing Address - Country:US
Mailing Address - Phone:845-558-1945
Mailing Address - Fax:
Practice Address - Street 1:173 W 78TH ST APT 11C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6708
Practice Address - Country:US
Practice Address - Phone:845-558-1945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst