Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 185933 | NY |
Y | 2080P0203X | Pediatric Critical Care Doctor | 185933 | NY |
NPI | 1134189897 |
---|---|
Provider Name | Talaat Abdelmoneim |
First Address | Hartford, CT 06150 |
Second Address | Dix Hills, NY 11746-5402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 05/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01676017 | (05) | NY |
F01265 | (02) |