Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 006521 | NY |
NPI | 1407096274 |
---|---|
Provider Name | Dr. Alexander Nmoma JR. |
First Address | Bronx, NY 10461-4058 |
Second Address | New York, NY 10038-2717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2009 |
Last Update Date | 21/06/2013 |