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Organization
NOVA VITA MEDICAL PC
Active
Organization
NOVA VITA MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
UBONG JACKSON UDOYEN (MD)
(803) 269-7381
Entity
Organization
Contact information
Practice address
887 RUTLAND RD, BROOKLYN, NY 11203
(347) 627-6385
(347) 413-9888
Mailing address
887 RUTLAND RD, BROOKLYN, NY 11203-1911
(347) 627-6385
(347) 413-9888
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
NULL
207K00000X
Allergy & Immunology Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
08/07/2017
Last updated
05/22/2018
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