NPI 1003268301

Vincent Setiawan Prawoko, MD

Practitioner Student in an Organized Health Care Education/Training Program Bronx, NY

Practice location

Address: 1650 Grand Concourse, Bronx, NY 10457-7606
Phone: (347) 601-1241
Fax: (718) 960-2055

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in New York →

Registry record

NPI: 1003268301
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jul 2016
Record last updated: 11 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.