DAVID WIDJAJA

BRONX, NY
NPI1194985291
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RG0100X Internal Medicine, Gastroenterology
(Licence: NY  275018)
Additional Taxonomies207RG0300X Internal Medicine, Geriatric Medicine
(Licence: NY  275018)
207R00000X Internal Medicine
(Licence: NY  275018)
Enumeration Date2008-06-11
Last Update Date2014-05-14
Business Address
-- DAVID WIDJAJA MD
1650 GRAND CONCOURSE
BRONX, NY 10457-7606
Phone number: 718-960-1234
Mailing Address
-- DAVID WIDJAJA MD
1650 SELWYN AVE 10TH FLOOR
BRONX, NY 10457-7626
Phone number: 718-960-1234