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1639755218
MUDASSIR MUMTAZ
PORT JEFFERSON, NY
NPI
1639755218
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-03-23
Last Update Date
2021-03-23
Business Address
MUDASSIR MUMTAZ MD
75 N COUNTRY RD
PORT JEFFERSON, NY 11777-2190
Phone number: 631-686-2549
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Mailing Address
MUDASSIR MUMTAZ MD
75 N COUNTRY RD
PORT JEFFERSON, NY 11777-2190
Phone number: 631-686-2549
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