Individual
DR. IVY DWOMOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
506 LENOX AVNEUE, NEW YORK, NY 10037-1802
(212) 939-1000
Mailing address
315 E 167TH ST APT 6B, BRONX, NY 10456-4054
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
60106
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/23/2015
Last updated
03/21/2018
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