Individual
DR. MUMTAZ MOHIDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
431 DEER PARK AVE, BABYLON, NY 11702-2315
(631) 376-1101
(631) 376-1139
Mailing address
431 DEER PARK AVE, BABYLON, NY 11702-2315
(631) 376-1101
(631) 376-1139
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
184482
NY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
184482
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184482
LICENSE
NY
01
—
2511488
GHI
NY
01
—
3X1011
EMPIRE BCBS
NY
Enumeration date
05/16/2006
Last updated
11/05/2009
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