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General NPI Number Information
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NPI Number | 1396103982
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Entity Type | Organization
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Legal Business Name | GO AFRICA HEALTH
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 543 W 141ST ST
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City | NEW YORK
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State | NY
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Zip | 10031-7026
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Country | US
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Telephone | 917-447-4922
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Fax |
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Provider Business Mailing Address
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Address Line | 1760 2ND AVE SUITE 22C
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City | NEW YORK
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State | NY
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Zip | 10128-5329
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Country | US
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Telephone | 917-447-4922
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. SAMUEL JONES
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Credential | M.D.
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Telephone | 917-447-4922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 182228
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License Number State | NY
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