Individual
ALEXANDER BOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-6100
Mailing address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-6100
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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