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Individual
PANKAJ K MAMTORA
Active
Individual
PANKAJ K MAMTORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
183635
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01456968
—
NY
01
—
29I692
EMPIRE BS BC ON NY
NY
Enumeration date
10/19/2006
Last updated
06/02/2023
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