Provider Demographics
NPI:1700611506
Name:MIESES, APRIL CHEREA
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:CHEREA
Last Name:MIESES
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 1:5607 KAITLYN DR W
Mailing Address - Street 2:
Mailing Address - City:WALLS
Mailing Address - State:MS
Mailing Address - Zip Code:38680-8526
Mailing Address - Country:US
Mailing Address - Phone:901-378-6672
Mailing Address - Fax:
Practice Address - Street 1:1820 AVENUE M # 957
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5347
Practice Address - Country:US
Practice Address - Phone:901-378-6672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4062712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry