Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 003034 | NY |
Y | 208600000X | Surgeon | 003034 | NY |
N | 208200000X | Surgeon | 003034 | NY |
N | 208600000X | Surgeon | 003034 | NY |
N | 2086S0102X | Surgical Critical Care | 003034 | NY |
N | 2086S0127X | Trauma Surgeon | 003034 | NY |
NPI | 1457514226 |
---|---|
Provider Name | Mohamed Elfar |
First Address | Middletown, NY 10940-2650 |
Second Address | Middletown, NY 10940-2650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 23/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03158032 | (05) | NY |