Individual
KATLIN DAVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
79 MORNINGSIDE AVE, SOUTH RIVER, NJ 08882-2139
(718) 510-6813
Mailing address
79 MORNINGSIDE AVE, SOUTH RIVER, NJ 08882-2139
(718) 510-6813
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1432276201
NY
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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