| Koku Gasinu Physician P.c. | |
|
2115 Starling Ave Bronx NY 10462-4311 | |
| (718) 822-2810 | |
| (718) 822-8732 |
| Full Name | Koku Gasinu Physician P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2115 Starling Ave, Bronx, New York |
| Authorized Official Name and Position | Koku Gasinu (OWNER) |
| Authorized Official Contact | 7188222810 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koku Gasinu Physician P.c. 2115 Starling Ave Bronx NY 10462-4311 Ph: (718) 822-2810 | Koku Gasinu Physician P.c. 2115 Starling Ave Bronx NY 10462-4311 Ph: (718) 822-2810 |
| NPI Number | 1265788566 |
|---|---|
| Provider Enumeration Date | 07/24/2012 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265788566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 60 164779 (New York) | Primary |
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