Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 154732 | NY |
NPI | 1043343726 |
---|---|
Provider Name | Dr. Mohamed Egal |
First Address | Oneonta, NY 13820 |
Second Address | Oneonta, NY 13820-2046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 12/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00809632 | (05) | NY |
B11574 | (02) | NY |