Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 235619 | NY |
N | 111NI0900X | Internist | 235619 | NY |
N | 207RC0200X | Critical Care Medicine | 235619 | NY |
Y | 207RP1001X | Pulmonary Disease | 235619 | NY |
NPI | 1033108303 |
---|---|
Provider Name | Dr. Mustafa Salehmohamed |
First Address | Flushing, NY 11355-5045 |
Second Address | Flushing, NY 11355-5045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 06/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03159253 | (05) | NY |