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1538364989
INSOO OM
BRONX, NY
NPI
1538364989
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 004057)
Enumeration Date
2007-06-17
Last Update Date
2007-07-08
Business Address
INSOO OM PA
220 E 161ST ST
BRONX, NY 10451-3543
Phone number: 718-537-1100
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Mailing Address
INSOO OM PA
7 FORSYTHIA LN
JERICHO, NY 11753-2326
Phone number: 347-512-6205
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