Individual
MISS CHIDIMMA MARILYN OBIEFULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2014 EDENWALD AVE, BRONX, NY 10466-2212
(973) 991-7258
(718) 960-9154
Mailing address
2014 EDENWALD AVE, BRONX, NY 10466-2212
(973) 991-7258
(718) 960-9154
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006702
NY
225200000X
Physical Therapy Assistant
40QB00238100
NJ
Other
Enumeration date
04/06/2007
Last updated
06/01/2011
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