Individual
MS. KATIA DERTHICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
726 BROADWAY FL 4, NEW YORK, NY 10003-9616
(212) 443-1000
Mailing address
394 LINCOLN PL APT C3, BROOKLYN, NY 11238-5819
(828) 545-0395
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
CNM05134
NY
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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