Miko E Douglas | Englewood, NJ • PECOS Search

Miko E Douglas

Social Worker

Behavioral Health & Social Service Providers

61 Grand Ave Ste 1, Englewood, NJ 07631-3599

(201) 541-8600 (914) 384-9852

PECOS Enrollment

Based on the most recent information from CMS, provider Miko E Douglas does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1114576287
Provider Type
Individual
Full Name
Douglas, Miko E
Title
Ms.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
9/10/2019
Last Updated
9/10/2019

Contact Information

Practice Location

61 Grand Ave Ste 1, Englewood, NJ 07631-3599

(201) 541-8100

Mailing Location

PO Box 1701, Ossining, NY 10562-0075

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer