Individual
DARYL AMA BOSOMPEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601
(551) 996-2331
Mailing address
46 ANDERSON ST, HACKENSACK, NJ 07601-4570
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA10375200
NJ
Other
Enumeration date
06/12/2015
Last updated
07/11/2018
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