Individual
MR. OMODELLE FITZHERBERT CRUM-EWING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN (BSN)
Contact information
Practice address
4165 HILL AVE, BRONX, NY 10466-2105
(646) 938-8603
(718) 547-4147
Mailing address
4165 HILL AVE, BRONX, NY 10466-2105
(646) 938-8603
(718) 547-4147
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
535857
NY
163WS0200X
School Registered Nurse
Primary
535857
NY
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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