Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RS0012X | Sleep Medicine | 34062 | OK |
NPI | 1033505490 |
---|---|
Provider Name | Mohsin Mansoor |
First Address | East Meadow, NY 11554-1859 |
Second Address | East Meadow, NY 11554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 16/08/2018 |