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General NPI Number Information
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NPI Number | 1003617291
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Entity Type | Individual
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Provider Name | MOHAMMAD SHIGRI
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Gender | Male
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 19460A 64TH AVE APT 2A
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-2837
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Country | US
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Telephone | 516-547-7769
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Fax |
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Provider Business Mailing Address
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Address Line | 19460A 64TH AVE APT 2A
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-2837
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | EL7224
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License Number State | CA
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