Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 100008 | NY |
NPI | 1023181948 |
---|---|
Provider Name | Noel Omar Mohammed |
First Address | Saint James, NY 11780-0496 |
Second Address | Stony Brook, NY 11790-3191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |