National Provider Identifier
Roodlyne Kimberly Antenor, PA-C
Roodlyne Kimberly Antenor, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (607) 274-3011.
Profile Overview
- NPI
- 1871369108
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- November 28, 2023
- Last Updated
- November 28, 2023
Practice Location
- 215 E State St
- Ithaca, NY 14850-5547
Phone: (607) 274-3011
Mailing Address
- 1341 Nw 132Nd Ter
- Miami, FL 33167-1720
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1871369108
- Entity Type
- Individual
- Last Name
- Antenor
- First Name
- Roodlyne
- Middle Name
- Kimberly
- Credential
- PA-C
- Mailing Street Address
- 1341 Nw 132Nd Ter
- Mailing City
- Miami
- Mailing State
- FL
- Mailing ZIP Code
- 33167-1720
- Mailing Country
- US
- Mailing Phone
- (786) 506-3794
- Practice Street Address
- 215 E State St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5547
- Practice Country
- US
- Practice Phone
- (607) 274-3011
- Enumeration Date
- November 28, 2023
- Last Updated
- November 28, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- November 28, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)