AINIE SOETANTO

BRONX, NY
NPI1942640644
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: NY  289406)
Additional Taxonomies2084V0102X Psychiatry & Neurology, Vascular Neurology
(Licence: NY  289406)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: PA  26938410)
Enumeration Date2013-06-27
Last Update Date2025-04-30
Business Address
AINIE SOETANTO M.D.
111 E 210TH ST
BRONX, NY 10467-2401
Phone number: 718-920-2625
Mailing Address
AINIE SOETANTO M.D.
111 E 210TH ST
BRONX, NY 10467-2401
Phone number: 718-920-2625