Individual
CHAIM WANOUNOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
100 ROSS ST, BROOKLYN, NY 11211-7672
(718) 387-7628
Mailing address
1648 RYDER ST, BROOKLYN, NY 11234-4307
(718) 253-0648
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007367
NY
Other
Enumeration date
06/28/2005
Last updated
12/21/2011
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