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Organization
MSU MEDICAL PC
Active
Organization
MSU MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED ULLAH MD (OWNER-PRESIDENT)
(917) 293-3414
Entity
Organization
Contact information
Practice address
84 05 169TH STREET, JAMAICA HILLS, NY 11432
(718) 657-8001
(718) 732-0783
Mailing address
84 05 169TH STREET, JAMAICA HILLS, NY 11432
(718) 657-8001
(718) 732-0783
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
249483
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03019909
—
NY
Enumeration date
08/09/2012
Last updated
08/09/2012
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