Individual
DR. MUSTAFA KAAKOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1656 CHAMPLIN AVE, DEPARTMENT OF PATHOLOGY, UTICA, NY 13502-4830
(315) 797-0790
(315) 624-8204
Mailing address
117 SYLVAN WAY, NEW HARTFORD, NY 13413-3436
(315) 724-4429
(315) 724-4429
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
1894621
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
1894621
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81472
EMPIRE BC BS
NY
Enumeration date
12/19/2006
Last updated
09/11/2025
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