Individual
MOHAMED BAYOUMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2 EXECUTIVE PARK DR, ALBANY, NY 12203-3700
(518) 446-1001
(518) 446-0802
Mailing address
2 EXECUTIVE PARK DR, ALBANY, NY 12203-3700
(518) 446-1001
(518) 446-0802
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
061102
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
AH1918018-7009
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508229402
OFFICE
MA
Enumeration date
03/30/2016
Last updated
08/10/2020
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