Individual
MINOU ABSY-JAGHAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 GRAND CONCOURSE, BRONX, NY 10451-5430
(917) 645-0258
Mailing address
2201 HEMSPTEAD TPKE, EAST MEADOW, NY 11554
(516) 572-3924
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
128865
NY
207RI0200X
Infectious Disease Physician
Primary
128865
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113465690
ETIN 113465690
NY
01
—
2154315
UNITED EMPIRE
NY
01
—
4318302
AETNA
NY
Enumeration date
06/19/2006
Last updated
09/25/2013
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