Individual
MOMEN M ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 64TH ST, BROOKLYN, NY 11220-4900
(718) 630-1310
Mailing address
420 64TH ST, BROOKLYN, NY 11220-4900
(718) 630-1310
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
326726
NY
Other
Enumeration date
04/24/2020
Last updated
05/13/2024
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