Individual
EPIFANIA BONQUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
367 E 204TH ST APT 2, BRONX, NY 10467-4701
(914) 481-9465
Mailing address
367 E 204TH ST APT 2, BRONX, NY 10467-4701
(914) 481-9465
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-2427910
—
NY
Enumeration date
09/21/2022
Last updated
09/21/2022
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