DEEDEE IMAFORTOR EBALU

BROOKLYN, NY
NPI1548853211
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  026338)
Enumeration Date2021-02-14
Last Update Date2021-02-14
Business Address
Miss DEEDEE IMAFORTOR EBALU PA-C
1349 BROADWAY
BROOKLYN, NY 11221-6162
Phone number: 718-975-2270
Mailing Address
Miss DEEDEE IMAFORTOR EBALU PA-C
1135 WARD AVE APT 1
BRONX, NY 10472-3801
Phone number: 347-220-2814
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