Individual
DANVAS BOGONKO GICHANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 E 79TH ST, NEW YORK, NY 10075-0819
(212) 879-1600
Mailing address
430 RALPH ST, SOMERSET, NJ 08873-3142
(721) 621-9425
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
011326
NY
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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