Individual
DR. AVWEROSUOGHENE JUDE ITEDJERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 E 187TH ST, BRONX, NY 10458-6706
(718) 365-8630
Mailing address
619 E 187TH ST, BRONX, NY 10458-6706
(718) 365-8630
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
066801
NY
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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