Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 243722 | NY |
Y | 111NI0900X | Internist | 243722 | NY |
N | 207RH0002X | Hospice and Palliative Medicine | 60-243722 | NY |
NPI | 1285854166 |
---|---|
Provider Name | Dr. Hany Kamal Mosaad-Boktor |
First Address | Elmira, NY 14901-3230 |
Second Address | Elmira, NY 14905-1629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 16/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02960929 | (05) | NY |