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General NPI Number Information
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NPI Number | 1063484582
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Entity Type | Individual
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Provider Name | MAHMOUD I HAMZA MD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 29 CHURCH ST
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City | LAKE PLACID
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State | NY
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Zip | 12946-1805
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Country | US
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Telephone | 518-523-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 84 N OHIOVILLE RD
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City | NEW PALTZ
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State | NY
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Zip | 12561-3400
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Country | US
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Telephone | 845-853-5909
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101269291
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 237858-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 26454
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License Number State | WV
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