Individual
EDWIGE ADOUBIA SAMOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
234 E 149TH ST, BRONX, NY 10451-5589
(718) 579-5000
Mailing address
4206 E TREMONT AVE, BRONX, NY 10465-3320
(917) 288-3770
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F350972-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F350972-01
—
NY
Enumeration date
12/19/2022
Last updated
12/19/2022
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