Individual
MS. MITSOU DOROTI PHILOGENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
234 E 149TH ST, BRONX, NY 10451-5589
(718) 579-4635
Mailing address
1164 EAST 38TH STREET, BROOKLYN, NY 11210
(929) 234-8801
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F309059-1
NY
Other
Enumeration date
12/11/2012
Last updated
04/26/2019
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