Individual
MRS. MARY LIJI KALATHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
12 FAIRMONT AVE, ARDSLEY, NY 10502-1618
(914) 393-5275
Mailing address
12 FAIRMONT AVE, ARDSLEY, NY 10502-1618
(914) 393-5275
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
350447
NY
Other
Enumeration date
10/06/2018
Last updated
10/06/2018
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