Individual ProviderJacqueline MedinaSpecialistOther Service ProvidersPractice Address253 E 142nd St Apt 6p, Bronx, NY 10451-5947(646) 318-2093PECOS EnrollmentBased on the most recent information from CMS, provider Jacqueline Medina does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:05 AM.Profile DetailsProvider ID1346024882Provider TypeIndividualFull NameMedina, JacquelineGenderFemaleSole ProprietorYesEnumeration Date8/24/2023Last Updated5/15/2025Contact InformationPractice LocationPractice Address253 E 142nd St Apt 6p, Bronx, NY 10451-5947Phone(646) 318-2093FaxUnlisted FaxMailing LocationMailing Address253 E 142nd St Apt 6p, Bronx, NY 10451-5947Phone(646) 318-2093FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicenseUnlisted IssuerCode106E00000XDescriptionAssistant Behavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerNew York