Individual
GHASSEM MANGOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 RIVERSIDE DR, JOHNSON CITY, NY 13790-2708
(607) 798-0706
Mailing address
355 RIVERSIDE DR, JOHNSON CITY, NY 13790-2708
(607) 798-0706
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
154223
NY
Other
Enumeration date
10/28/2005
Last updated
07/08/2007
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