Individual
MAHYAR MAHMOUDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 DEKALB AVE, BROOKLYN, NY 11201-5425
(718) 250-6946
Mailing address
722 W. WATER STREET, ELMIRA, NY 14905-2435
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
277972
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2014
Last updated
08/24/2015
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