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NPI Code Detail

MEDICARE: SEFAN RYAN MOLLAH DO

MEDICARE: SEFAN RYAN MOLLAH DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician345855NY

General Provider Information

NPI Number : 1104558832
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEFAN RYAN MOLLAH DO
Provider Business Mailing Address
First Line : 1 BROOKDALE PLZ
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-3139
Country : US
Telephone Number : 718-240-5473
Fax Number :
Provider Business Practice Location Address
First Line : 1 BROOKDALE PLZ
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-3139
Country : US
Telephone Number : 718-240-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2022
Last Update Date : 06/24/2026

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Directions to “ SEFAN RYAN MOLLAH DO” Practice Location

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