Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 241340 | NY |
NPI | 1124223722 |
---|---|
Provider Name | Dr. Ayman Mohammed Omar Mansour |
First Address | Rego Park, NY 11374-4621 |
Second Address | New York, NY 10021-4872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |