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Individual

GEOGE MANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
13302 41ST AVE, FLUSHING, NY 11355-3629
(718) 886-1150
(718) 886-1185
Mailing address
PO BOX 520112, FLUSHING, NY 11352-0112
(718) 886-8180
(718) 732-2062

Taxonomy

Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
188903
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01663538
NY
Enumeration date
10/16/2006
Last updated
07/08/2007
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