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1497045371
IDA K ETAH
BRONX, NY
NPI
1497045371
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY F336219)
Enumeration Date
2011-04-13
Last Update Date
2019-10-22
Business Address
IDA K ETAH FNP
2960 MICKLE AVE
BRONX, NY 10469-3304
Phone number: 646-683-1949
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Mailing Address
IDA K ETAH FNP
2960 MICKLE AVE
BRONX, NY 10469-3304
Phone number: 646-683-1949
Copy
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