Individual
KABWE KABONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
290 LENOX AVE, NEW YORK, NY 10027-4991
(212) 663-3000
Mailing address
4418 BRUNER AVE, BRONX, NY 10466-1214
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
808923
NY
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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