Provider Demographics
NPI:1619772456
Name:LUDDY, KATRINE VALENTINA (PA-C)
Entity type:Individual
Prefix:
First Name:KATRINE
Middle Name:VALENTINA
Last Name:LUDDY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 W SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2024
Mailing Address - Country:US
Mailing Address - Phone:201-394-8159
Mailing Address - Fax:
Practice Address - Street 1:527 W SADDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2024
Practice Address - Country:US
Practice Address - Phone:201-394-8159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant