Provider Demographics
NPI:1154751246
Name:ARBOLEDA, KATHERINE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ARBOLEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14308 ROOSEVELT AVE
Mailing Address - Street 2:APT. 104
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-6146
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14308 ROOSEVELT AVE
Practice Address - Street 2:APT. 104
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6146
Practice Address - Country:US
Practice Address - Phone:718-380-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator