Individual
MAHUM INAM RIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(434) 466-5976
(631) 376-3420
Mailing address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 376-3420
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102208079
VA
207P00000X
Emergency Medicine Physician
7077
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2019
Last updated
09/25/2023
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