Individual
PARVIZ R MOHASSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
123 PIKE ST, SUITE 209, PORT JERVIS, NY 12771-1824
(845) 856-6671
(845) 858-9903
Mailing address
PO BOX 1004, PORT JERVIS, NY 12771-0194
(845) 856-6671
(845) 858-9903
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
174612
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01353364
—
NY
Enumeration date
07/30/2006
Last updated
07/08/2007
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