Organization
LA RISARALDA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMIN VANEGAS (MANAGER)
(917) 584-3840
Entity
Organization
Contact information
Practice address
9104 37TH AVE, JACKSON HEIGHTS, NY 11372-7920
(718) 651-2015
Mailing address
9104 37TH AVE, JACKSON HEIGHTS, NY 11372-7920
(718) 651-2015
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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