Individual
KIMONA ISSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
65 PENNSYLVANIA AVE, BINGHAMTON, NY 13903-1651
(607) 798-9356
Mailing address
23 MINNISINK RD, WAYNE, NJ 07470-4810
(661) 645-8397
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
52114
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2014
Last updated
05/02/2021
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