Individual
AUGUSTINA EKEZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 E 241ST ST, BRONX, NY 10470-1303
(718) 671-2100
Mailing address
2110 PITMAN AVE, BRONX, NY 10466-1916
(646) 271-7886
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
334642
NY
Other
Enumeration date
03/29/2019
Last updated
03/29/2019
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