Individual
MRS. MIEMIE VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2500
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6416321
NY
Other
Enumeration date
03/01/2018
Last updated
03/27/2023
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