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Organization
NEW DORP MEDICAL PC
Active
Organization
NEW DORP MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED A ELSOURY MD (SOLE OWNER)
(718) 987-8600
Entity
Organization
Contact information
Practice address
4247 RICHMOND AVE, STATEN ISLAND, NY 10312-6220
(718) 605-4000
Mailing address
4247 RICHMOND AVE, STATEN ISLAND, NY 10312-6220
(718) 605-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/29/2007
Last updated
02/04/2011
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