Provider Demographics
NPI:1992134860
Name:BOLDRINI-SENN, KIMBERLY CLARA (LAC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CLARA
Last Name:BOLDRINI-SENN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 PARK ST STE 2W-3
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-3491
Mailing Address - Country:US
Mailing Address - Phone:917-456-6385
Mailing Address - Fax:844-401-8624
Practice Address - Street 1:1006 PARK ST STE 2W-3
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-3802
Practice Address - Country:US
Practice Address - Phone:917-456-6385
Practice Address - Fax:844-401-8624
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006141171100000X
CT725171100000X
OR165166171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist