Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 203395-1 | NY |
NPI | 1063404234 |
---|---|
Provider Name | Dr. Mohammed A. Monzur |
First Address | Albany, NY 12209-1718 |
Second Address | Albany, NY 12209-1718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01807309 | (05) | NY |
G64538 | (02) |