Provider Information for 1669946570
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Mrs. KIMARA ROSITA RUNCIE NCC
Sex: Female
NPI: 1669946570
Last Updated: 2024-01-08
Certification Date: 2024-01-08
Certification Date: 2024-01-08
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669946570 | ||||||||||||
| Enumeration Date | 2019-01-14 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 286 5TH AVE NEW YORK, NY 10001-4512 United States Phone: 718-236-0774 | Fax: | ||||||||||||
| Primary Practice Address | 286 5TH AVE UNIT 1001 NEW YORK, NY 10001-4512 United States Phone: 718-236-0774 | Fax: | ||||||||||||
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