Individual
MANSOOR AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 NICOLLS RD, STONY BROOK, NY 11794-8166
(631) 444-1617
(631) 546-7004
Mailing address
100 NICOLLS RD, STONY BROOK, NY 11794-8166
(631) 444-1617
(631) 546-7004
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
000000
NY
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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