Individual
NAPHPA BOONPANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1470 MADISON AVE, NEW YORK, NY 10029-6542
(212) 241-7873
Mailing address
4807 PIN OAK PARK APT 12104, HOUSTON, TX 77081-2179
(281) 216-4618
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308879
NY
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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