Individual
DR. FOMA MUNOH KENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
355 BARD AVE, VILLA BLDG 1ST FLOOR, STATEN ISLAND, NY 10310-1664
(718) 818-2419
Mailing address
355 BARD AVE DEPT OF, VILLA BLDG 1ST FLOOR, STATEN ISLAND, NY 10310-1664
(718) 818-2419
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101270130
VA
207R00000X
Internal Medicine Physician
Primary
306429
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2017
Last updated
10/30/2020
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