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General NPI Number Information
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NPI Number | 1457500100
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Entity Type | Individual
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Provider Name | MANDIP DHAMOON MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 722 W 168TH ST # 206
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City | NEW YORK
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State | NY
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Zip | 10032-3727
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Country | US
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Telephone | 917-899-4259
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Fax |
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Provider Business Mailing Address
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Address Line | 722 W 168TH ST # 206
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City | NEW YORK
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State | NY
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Zip | 10032-3727
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Country | US
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Telephone | 917-899-4259
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 240860
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License Number State | NY
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