Individual
KATHERINE SHEA PULVIDENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 FRANKLIN BLVD APT 3N, LONG BEACH, NY 11561-4502
(631) 942-2224
Mailing address
25 FRANKLIN BLVD APT 3N, LONG BEACH, NY 11561-4502
(631) 942-2224
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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