Provider Demographics
NPI:1588410161
Name:IDROVO, KATHERINE L (RN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:IDROVO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:L
Other - Last Name:IDROVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5 ROYCE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-5298
Mailing Address - Country:US
Mailing Address - Phone:845-598-4993
Mailing Address - Fax:
Practice Address - Street 1:5 ROYCE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5298
Practice Address - Country:US
Practice Address - Phone:845-598-4993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY891853163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health