Individual
DR. ALIASGHAR MOHYUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1780 HANSHAW RD, ITHACA, NY 14850-9105
(607) 257-5858
(607) 257-1718
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
215037-1
NY
207R00000X
Internal Medicine Physician
MD068766L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017551190001
—
PA
05
—
01980905
—
NY
01
—
110209182
RR MEDICARE PIN
NY
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
GU039894
PA MEDICARE GROUP
PA
Enumeration date
02/03/2006
Last updated
09/15/2011
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