# PARK PLACE MEDICAL P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932389731
- **Authorized official:** DR. MOHAMMED MANSOUR M.D. (PRESIDENT)
- **Authorized official phone:** (718) 773-2011

## Contact information

- **Practice address:** 2912 210TH PL, BAYSIDE, NY 11360-2433
- **Practice address phone:** (718) 773-2011
- **Practice address fax:** (718) 773-3728
- **Mailing address:** 910 PARK PL, SUITE 1-B, BROOKLYN, NY 11216-4000
- **Mailing address phone:** (718) 773-2011
- **Mailing address fax:** (718) 773-3728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 191343 | NY | Yes |

## Other

- **Enumeration date:** 11/08/2007
- **Last updated:** 11/08/2007