Individual
MISS EBONY YVETTE BROMFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-6626
Mailing address
28 THOMAS ST, CORAM, NY 11727-3152
(917) 589-2721
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011438
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011438
PA STATE LICENSE
NY
Enumeration date
03/28/2007
Last updated
11/30/2011
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