Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 264247 | MA |
N | 111NI0900X | Internist | 264247 | MA |
Y | 207WX0107X | Retina Specialist | 298718 | NY |
NPI | 1003298365 |
---|---|
Provider Name | Mhd Abdallah Mahrous |
First Address | New York, NY 10021-5663 |
Second Address | New York, NY 10021-5663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2015 |
Last Update Date | 06/06/2019 |