Individual
MIREILLE ZITA AGOKENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
234 E 149TH ST, BRONX, NY 10451-5504
(718) 579-5000
Mailing address
836 MORRIS PARK AVE APT 2, BRONX, NY 10462-3677
(646) 732-5581
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
347027
NY
Other
Enumeration date
04/10/2021
Last updated
04/10/2021
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