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1255073045
IDAN BOUSSANI
BROOKLYN, NY
NPI
1255073045
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-04-12
Last Update Date
2022-04-12
Business Address
IDAN BOUSSANI DO
450 CLARKSON AVE
BROOKLYN, NY 11203-2012
Phone number: 718-270-1984
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Mailing Address
IDAN BOUSSANI DO
450 CLARKSON AVE
BROOKLYN, NY 11203-2012
Phone number: 718-270-1984
Copy
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