Individual
MR. JOHANNES KEE GUNAWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
680 CONNECTICUT AVE, NORWALK, TN 06854
(203) 854-8519
(203) 854-9526
Mailing address
39 MONROE STREET APARTMENT # 1, NEW YORK, NY 10002
(917) 324-7337
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8699
CT
Other
Enumeration date
11/15/2007
Last updated
11/15/2007
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