Individual
MR. ONWEREMADU GOGOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 E 221ST ST, BRONX, NY 10467-5110
(917) 586-3572
Mailing address
673 S 7TH AVE, MOUNT VERNON, NY 10550-4825
(917) 586-3572
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
438375475
NY
Other
Enumeration date
04/03/2015
Last updated
04/03/2015
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