Individual
OSAMEDE IRENE EGHAREVBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1375 MACE AVE, BRONX, NY 10469-5632
(718) 547-8325
Mailing address
1375 MACE AVE, BRONX, NY 10469-5632
(718) 547-8325
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
609356-1
NY
Other
Enumeration date
10/09/2017
Last updated
10/09/2017
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