Individual
DR. TIA MANSOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
461 1ST AVE, NEW YORK, NY 10016-9102
(125) 624-9912
Mailing address
1 PARK AVE FL 7, NEW YORK, NY 10016-5818
(646) 754-5000
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
300588
NY
Other
Enumeration date
03/29/2016
Last updated
09/06/2022
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