Most Relevant Information
Provider Data
| NPI Number: | 1003272824 |
| Provider Name: | KORKOH-JAH MAMIEDEE GEORGE FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 33-337626 |
Most Important Dates
| Enumeration Date: | 01/08/2016 |
| Last Updated: | 01/08/2016 |
Provider Practice Location
306 W 114TH ST APT 4D
NEW YORK
NY
100262746
Practice Location Phone/Fax
| Phone: | 6463202712 |
| Fax: |
Provider Mailing Location
306 W 114TH ST APT 4D
NEW YORK
NY
100262746
Provider Mailing Phone/Fax
| Phone: | 6463202712 |
| Fax: |