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1558011023
FITRA RIANTO
BRONX, NY
NPI
1558011023
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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
2022-03-26
Last Update Date
2022-03-26
Business Address
Dr. FITRA RIANTO MD
111 E 210TH ST
BRONX, NY 10467-2401
Phone number: 718-920-6573
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Mailing Address
Dr. FITRA RIANTO MD
2725 BROWN AVE
DURHAM, NC 27705-4405
Phone number: 469-347-9297
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