Individual
LAWRENCE OSE IFIDON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
529 COURTLANDT AVE, BRONX, NY 10451-5007
(718) 654-0730
Mailing address
39 ROSSITER AVE, YONKERS, NY 10701-5008
(646) 242-8956
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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