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1760906143
EBENEZER VANDER PALLEN
STATEN ISLAND, NY
NPI
1760906143
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy
(Licence: NY 720270)
Enumeration Date
2017-07-27
Last Update Date
2017-07-27
Business Address
EBENEZER VANDER PALLEN RN
1366 VICTORY BLVD # B
STATEN ISLAND, NY 10301-3907
Phone number: 718-442-8351
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Mailing Address
EBENEZER VANDER PALLEN RN
1491 MACOMBS RD APT 8D
BRONX, NY 10452-2145
Phone number: 718-864-7922
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