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Individual

BO CUI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4422 3RD AVE, BRONX, NY 10457-2545
(718) 960-9000
Mailing address
6885 218TH ST, OAKLAND GARDENS, NY 11364-2610

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
299398
NY

Other

Enumeration date
05/25/2016
Last updated
06/17/2020
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