Individual
ANNE LUKUNDULA MUTOMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8944 162ND ST, JAMAICA, NY 11432-5045
(917) 520-3771
Mailing address
8944 162ND ST, JAMAICA, NY 11432-5045
(917) 520-3771
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
602510-1
NY
Other
Enumeration date
04/23/2009
Last updated
04/23/2009
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