Individual
EDITH ANTONIO BALDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 DUDLEY ST, PROVIDENCE, RI 02905-2499
(401) 274-1100
Mailing address
9724 42ND AVE, CORONA, NY 11368-2145
(917) 817-6347
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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