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General NPI Number Information
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NPI Number | 1396001061
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Entity Type | Individual
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Provider Name | BASHAR M MOURAD D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2012
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 301 E 17TH ST STE 550
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-598-6422
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Fax |
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Provider Business Mailing Address
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Address Line | 150 E 42ND ST FL 9
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City | NEW YORK
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State | NY
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Zip | 10017-5699
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Country | US
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Telephone | 646-605-8188
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Fax | 212-523-7410
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 290805
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 290805
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License Number State | NY
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