Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 175748 | NY |
NPI | 1861575136 |
---|---|
Provider Name | Massoud Benhuri |
First Address | Kings Point, NY 11024 |
Second Address | North Massapequa, NY 11758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01096657 | (05) | NY |
E48997 | (02) |