Individual
BENSON IROAMACHI MPAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
232 18 MERRICK BLVD, LAURELTON, NY 11413
(718) 528-3432
Mailing address
232 18 MERRICK BLVD, LAURELTON, NY 11413
(718) 528-3432
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
229153
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010556898
—
NY
Enumeration date
10/23/2008
Last updated
10/23/2008
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