Individual
CARLA RICCIARDONE DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
387 WATERBURY HILL RD, LAGRANGEVILLE, NY 12540-5320
(215) 341-1684
Mailing address
387 WATERBURY HILL RD, LAGRANGEVILLE, NY 12540-5320
(215) 341-1684
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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