Healthcare Provider Details

I. General information

NPI: 1083978233
Provider Name (Legal Business Name): MICHELE ALEXANDRA LIM LEDESMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 GRASSLANDS RD STE 200
VALHALLA NY
10595-1593
US

IV. Provider business mailing address

503 GRASSLANDS RD STE 200
VALHALLA NY
10595-1593
US

V. Phone/Fax

Practice location:
  • Phone: 914-304-5250
  • Fax: 914-345-1752
Mailing address:
  • Phone: 914-304-5250
  • Fax: 914-345-1752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number54337
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number295664
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number295664
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: