Individual
MS. CARMEN OBANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2431 SOUTHERN BLVD APT 1, BRONX, NY 10458-6520
(347) 271-3324
(718) 299-6578
Mailing address
2431 SOUTHERN BLVD APT 1, BRONX, NY 10458-6520
(347) 271-3324
(718) 299-6578
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
640027
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
640027
NEW YORK STATE CERTIFICATE
NY
Enumeration date
07/06/2012
Last updated
07/06/2012
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