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Individual

DR. HOMER MOUTRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
378 SEAVIEW AVE STE 2, STATEN ISLAND, NY 10305-2200
(718) 226-6110
Mailing address
501 SEAVIEW AVE STE 202, STATEN ISLAND, NY 10305-3400
(718) 226-6110

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
268503
NY

Other

Enumeration date
07/09/2010
Last updated
08/13/2021
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