Individual
FAY CALLEJO GBOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(877) 547-3763
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F310244
NY
Other
Enumeration date
06/21/2021
Last updated
02/20/2024
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