Individual
LAETITIA KAVANAGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
15 BRONXVILLE RD APT 2F, BRONXVILLE, NY 10708-6134
(914) 433-3735
Mailing address
15 BRONXVILLE RD APT 2F, BRONXVILLE, NY 10708-6134
(914) 433-3735
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
348799
NY
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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