Individual
BOLIVAR MONROY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
712 LOGAN AVE, BRONX, NY 10465-2329
(347) 419-4800
Mailing address
712 LOGAN AVENUE, BRONX, NY 10465
(347) 419-4800
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
664942
NY
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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