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Individual

DR. MUDAR DALLOUL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
450 CLARKSON AVE, SUITE G, BROOKLYN, NY 11203-2056
(718) 363-2908
(718) 270-4122
Mailing address
450 CLARKSON AVE, BOX 1262, BROOKLYN, NY 11203-2056
(718) 270-8867
(718) 270-1794

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
227244-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02377071
NY
Enumeration date
09/22/2005
Last updated
07/08/2007
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