Individual
MOOMITU KASHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15536 116TH DR, JAMAICA, NY 11434-1514
(347) 283-3623
Mailing address
15536 116TH DR, JAMAICA, NY 11434-1514
(347) 283-3623
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
029930-01
NY
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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