MEDICARE: MONA BASHAR MD

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	207R00000X	Internal Medicine Physician	205407-1	NY
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	205407-1	NY
3	207RP1001X	Pulmonary Disease Physician	205407-1	NY

General Provider Information

NPI Number	:	1932172699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONA BASHAR MD

Provider Business Mailing Address
First Line	:	305 2ND AVE
Second Line	:	SUITE 16
City	:	NEW YORK
State	:	NY
Zip	:	10003-2739
Country	:	US
Telephone Number	:	212-598-6516
Fax Number	:	212-598-6212

Provider Business Practice Location Address
First Line	:	305 2ND AVE
Second Line	:	SUITE 16
City	:	NEW YORK
State	:	NY
Zip	:	10003-2739
Country	:	US
Telephone Number	:	212-598-6516
Fax Number	:	212-598-6212

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	03/08/2021

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Directions to “ MONA BASHAR MD” Practice Location

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