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1912572934
FATU BANGURA
IRVINGTON, NJ
NPI
1912572934
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171W00000X Contractor
Additional Taxonomies
251X00000X
305S00000X Point of Service
Enumeration Date
2021-05-21
Last Update Date
2021-05-21
Business Address
FATU BANGURA
65-67 MELVILLE PLACE
IRVINGTON, NJ 07111
Phone number: 862-777-3526
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Mailing Address
FATU BANGURA
65-67 MELVILLE PLACE
IRVINGTON, NJ 07111
Phone number: 862-777-3526
Copy
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