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1184132110
EDWIN IDEMUDIA
BRONX, NY
NPI
1184132110
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 284010)
Enumeration Date
2018-01-11
Last Update Date
2018-01-11
Business Address
EDWIN IDEMUDIA
801 E 241ST ST
BRONX, NY 10470-1303
Phone number: 718-671-2100
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Mailing Address
EDWIN IDEMUDIA
1035 CLARKSON AVE APT 5C
BROOKLYN, NY 11212-1412
Phone number: 917-288-0129
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