Individual
DR. CHARLES A MANSOOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 E 64TH ST OFC 1, NEW YORK, NY 10065-7041
(646) 338-2345
Mailing address
188 E 64TH ST APT 302, NEW YORK, NY 10065-7461
(646) 338-2345
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
041470
NY
Other
Enumeration date
01/26/2010
Last updated
12/03/2020
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