Individual
DR. FARAGE MOUSSA NAWLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
201 A DYCKMAN STREET, NEW YORK, NY 10040
(212) 304-1728
(212) 304-3852
Mailing address
201 A DYCKMAN STREET, NEW YORK, NY 10040
(212) 304-1728
(212) 304-3852
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0474741
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01804695
—
NY
Enumeration date
03/02/2007
Last updated
07/08/2007
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