Individual
ELVIS MOKHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
27 WARREN ST, BRENTWOOD, NY 11717-1530
(631) 748-2156
Mailing address
27 WARREN ST, BRENTWOOD, NY 11717-1530
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
007387-1
NY
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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