Individual
HAZIM MOUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 COMMACK RD, COMMACK, NY 11725-5020
(631) 828-7220
(631) 828-7899
Mailing address
1500 ROUTE 112, PORT JEFFERSON STATION, NY 11776-8054
(631) 828-7220
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
331573
NY
Other
Enumeration date
03/28/2020
Last updated
11/05/2024
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