IVON LESTARI GOUTAMA

BRONX, NY
NPI1649030297
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-03-20
Last Update Date2024-03-20
Business Address
IVON LESTARI GOUTAMA MD
1650 GRAND CONCOURSE
BRONX, NY 10457-7697
Phone number: 718-960-1449
Mailing Address
IVON LESTARI GOUTAMA MD
640 W 237TH ST APT 11A
BRONX, NY 10463-1453
Phone number: 929-245-2803
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