Individual
DR. IBRAHIM AHMAD TANGOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2949 ERIE BOULEVARD EAST, SYRACUSE, NY 13224-1460
(315) 579-9037
(315) 424-1779
Mailing address
2949 ERIE BOULEVARD EAST, SYRACUSE, NY 13224-1460
(315) 579-9037
(315) 424-1779
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
209386
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01899210
—
NY
Enumeration date
09/16/2005
Last updated
10/25/2016
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