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General NPI Number Information
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NPI Number | 1083907612
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Entity Type | Individual
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Provider Name | LUDMILAR MESIDOR D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 3125 ROUTE 9W SUITE 204
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City | NEW WINDSOR
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State | NY
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Zip | 12553-6763
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Country | US
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Telephone | 914-302-3998
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Fax |
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Provider Business Mailing Address
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Address Line | 3125 ROUTE 9W SUITE 204
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City | NEW WINDSOR
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State | NY
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Zip | 12553-6763
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Country | US
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Telephone | 914-302-3998
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 51910
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34.013352
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0102205290
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2018-01518
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 04327
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DO034725
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License Number State | DC
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Taxonomy #7
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 286541
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License Number State | NY
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