Individual
MS. MIREILLE ALTIDORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2 1ST AVE, ORANGEBURG, NY 10962-1106
(845) 680-4000
Mailing address
27 SHARON DR, SPRING VALLEY, NY 10977-6030
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
819496
NY
164W00000X
Licensed Practical Nurse
330047
NY
Other
Enumeration date
10/18/2017
Last updated
12/05/2023
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