Provider Demographics
NPI:1083978233
Name:LEDESMA, MICHELE ALEXANDRA LIM (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE ALEXANDRA
Middle Name:LIM
Last Name:LEDESMA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:503 GRASSLANDS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1593
Mailing Address - Country:US
Mailing Address - Phone:914-304-5250
Mailing Address - Fax:914-345-1752
Practice Address - Street 1:503 GRASSLANDS RD STE 200
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1593
Practice Address - Country:US
Practice Address - Phone:914-304-5250
Practice Address - Fax:914-345-1752
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT54337208000000X
NY295664208000000X, 2080P0006X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program