Individual
KATRINA IM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
800 CROSS RIVER RD, KATONAH, NY 10536
(516) 578-1246
Mailing address
800 CROSS RIVER RD, KATONAH, NY 10536-3549
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
746849
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402462
NY
Other
Enumeration date
07/10/2018
Last updated
08/09/2018
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