Individual
HOMER CUNNINGHAM-DESHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
234 E 149TH ST, BRONX, NY 10451-5504
(718) 579-6011
(718) 570-4822
Mailing address
1058 E 99TH ST, BROOKLYN, NY 11236-4414
(718) 242-8578
(718) 241-8578
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303316
NY
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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