VINCENT SETIAWAN PRAWOKO

BRONX, NY
NPI1003268301
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2016-07-11
Last Update Date2016-07-11
Business Address
-- VINCENT SETIAWAN PRAWOKO MD
1650 GRAND CONCOURSE
BRONX, NY 10457-7606
Phone number: 347-601-1241
Mailing Address
-- VINCENT SETIAWAN PRAWOKO MD
1650 GRAND CONCOURSE
BRONX, NY 10457-7606
Phone number: 347-601-1241