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Individual

PUSHPOM Z JAMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2460 HYLAN BLVD, STATEN ISLAND, NY 10306-3117
(718) 226-5619
(718) 226-5620
Mailing address
131 9TH STREET, APT 1C, BROOKLYN, NY 11209
(347) 560-6044

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01031819A
IN
2080P0214X
Pediatric Pulmonology Physician
Primary
01031819A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03811323
NY
Enumeration date
03/23/2006
Last updated
09/01/2016
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