Individual
IBRAHIM MUBUSAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3029 AVENUE V, BROOKLYN, NY 11229-5448
(347) 254-6261
(347) 254-6445
Mailing address
614 RICHMOND RD, STATEN ISLAND, NY 10304-2410
(929) 293-4579
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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