Individual
MS. BOMA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
107 W 4TH ST, MOUNT VERNON, NY 10550-4002
(914) 699-7200
(914) 699-0837
Mailing address
107 WEST 4TH STREET, MOUNT VERNON, NY 10550
(914) 699-7200
(914) 699-0837
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
003455
NY
Other
Enumeration date
12/27/2007
Last updated
02/05/2014
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