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Individual

DR. KALU NDU BONIFACE AGWU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
506 LENOX AVE, HARLEM HOSPITAL, NEW YORK, NY 10037-2206
(212) 939-1000
Mailing address
37 WOODFIELD RD, POMONA, NY 10970-2216
(917) 744-0371

Taxonomy

Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
237607
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
237607
NEW YORK STATE LICENSE
NY
Enumeration date
07/26/2006
Last updated
03/26/2015
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