Individual
BONGI NKYRU DOUGHTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
555 EDGECOMBE AVE APT 12A, NEW YORK, NY 10032-4407
(646) 546-9939
Mailing address
555 EDGECOMBE AVE APT 12A, NEW YORK, NY 10032-4407
(646) 546-9939
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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