Individual
KATHERINE ELIZABETH LIDESTRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 10TH AVE, NEW YORK, NY 10019-1147
(212) 523-4000
Mailing address
1 BERNADETTE WAY, WASHINGTONVILLE, NY 10992-1754
(845) 325-7562
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
345899
NY
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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