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General NPI Number Information
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NPI Number | 1407185812
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Entity Type | Organization
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Legal Business Name | MOHAMED K. NOUR, MD. PC.
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Dates
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Enumeration Date | 12/14/2009
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Last Update Date | 12/14/2009
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Provider Practice Location Address
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Address Line | 168-01 12TH AVENUE RM 9D
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City | BEACH HILL
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State | NY
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Zip | 11357
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Country | US
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Telephone | 212-947-4799
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Fax |
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Provider Business Mailing Address
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Address Line | 168-01 12TH AVENUE RM 9D
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City | BEACH HILL
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State | NY
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Zip | 11357
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Country | US
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Telephone | 212-947-4799
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMED K NOUR
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Credential | MD
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Telephone | 212-947-4799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 126616
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License Number State | NY
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