Individual
FABIUS MEKONTCHOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2054 TILLOTSON AVE, BRONX, NY 10475-1560
(718) 671-2100
Mailing address
2601 OCEAN PKWY, BROOKLYN, NY 11235-7745
(347) 615-4803
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403247
NY
Other
Enumeration date
02/18/2013
Last updated
04/27/2021
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