Individual
ALICE TABISA NANYONGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
68 E 161ST ST, BRONX, NY 10451-2207
(718) 571-9139
(718) 571-9159
Mailing address
1345 RXR PLZ FL 13, UNIONDALE, NY 11556-1301
(516) 453-0435
(646) 846-3283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
263350
NY
Other
Enumeration date
07/03/2006
Last updated
12/06/2019
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