Individual
ADJA FOFANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 MCCLELLAN ST, 7A, BRONX, NY 10456-4807
(646) 420-0133
Mailing address
215 MCCLELLAN ST, 7A, BRONX, NY 10456-4807
(646) 420-0133
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
295488-1
NY
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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