Individual
MIDWIDGE STVIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
414 CLINTON AVE, ALBANY, NY 12206-2913
(917) 330-1721
Mailing address
30 O CONNELL ST APT 2, ALBANY, NY 12209-2255
(917) 330-1721
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
09/04/2023
Last updated
09/12/2023
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