Healthcare Provider Details

I. General information

NPI: 1982658779
Provider Name (Legal Business Name): VICTOR MOK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13630 MAPLE AVE SUITED 1I
FLUSHING NY
11355-3865
US

IV. Provider business mailing address

2 MOTT ST SUITE 304
NEW YORK NY
10013-5003
US

V. Phone/Fax

Practice location:
  • Phone: 718-461-1188
  • Fax: 718-461-2332
Mailing address:
  • Phone: 212-619-1815
  • Fax: 212-587-5676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number238118
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: