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Individual
MR. KELVIN OMONZANE
Active
Individual
MR. KELVIN OMONZANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
598996
NY
363LF0000X
Family Nurse Practitioner
Primary
338383
NY
Other
Enumeration date
12/19/2017
Last updated
02/16/2018
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