Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 297629 | NY |
NPI | 1003262452 |
---|---|
Provider Name | Nathalie Ragusa |
First Address | Washingtonvle, NY 10992-1178 |
Second Address | Washingtonville, NY 10992-2295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2016 |
Last Update Date | 15/01/2021 |