Individual
IBRAHIMA KOUROUMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 MYRTLE AVE APT 2, IRVINGTON, NJ 07111-6607
(973) 943-3768
Mailing address
216 MYRTLE AVE APT 2, IRVINGTON, NJ 07111-6607
(973) 943-3768
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ01180000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ01180000
NJ
NJ
Enumeration date
09/15/2021
Last updated
09/15/2021
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