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General NPI Number Information
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NPI Number | 1649077926
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Entity Type | Individual
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Provider Name | KIM M LAWLER -VILA
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Gender | Female
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 15 SUFFERN PL STE A
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City | SUFFERN
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State | NY
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Zip | 10901-5566
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Country | US
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Telephone | 845-357-4500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 323
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City | GREENWOOD LAKE
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State | NY
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Zip | 10925-0323
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Country | US
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Telephone | 845-500-3711
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 360043-01
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License Number State | NY
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