| NPI | 1003498163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATYA VICTORIA RIDORE Owner 914-340-3084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2025-09-30 |