Individual
CHIKA MIRIAM MBOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19 BRADHURST AVE, HAWTHORNE, NY 10532-2140
(914) 493-7701
Mailing address
19 BRADHURST AVE, HAWTHORNE, NY 10532-2140
(914) 493-7701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA12648600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2022
Last updated
10/26/2025
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