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General NPI Number Information
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NPI Number | 1720737539
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Entity Type | Individual
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Provider Name | ISRA HASSAN MUNIR DMD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2022
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 630 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3725
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Country | US
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Telephone | 212-305-7626
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Fax |
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Provider Business Mailing Address
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Address Line | 1134 CONCORD DR
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City | HADDONFIELD
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State | NJ
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Zip | 08033-3503
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Country | US
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Telephone | 856-323-3565
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI03005900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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