Individual
ISMAT MRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
191 N MAIN ST, WELLSVILLE, NY 14895-1150
(313) 657-3696
Mailing address
97 FAIRLAWN AVE, HORNELL, NY 14843-1744
(313) 657-3696
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
321205
NY
Other
Enumeration date
08/30/2021
Last updated
09/19/2023
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