MEDICARE: DR. NEVILLE KEKI MOBARAKAI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	195536	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639166309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEVILLE KEKI MOBARAKAI M.D.

Provider Business Mailing Address
First Line	:	33 SUNNYWOOD DR
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-4204
Country	:	US
Telephone Number	:	908-233-3523
Fax Number	:

Provider Business Practice Location Address
First Line	:	1408 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2312
Country	:	US
Telephone Number	:	718-979-5647
Fax Number	:	718-979-5650

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2005
Last Update Date	:	07/08/2007

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