Organization
PRR DIAGNOSTIC MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD MIRZA MD (DIRECTOR)
(973) 493-7607
Entity
Organization
Contact information
Practice address
1265 CLOVE RD, STATEN ISLAND, NY 10301-4339
(973) 493-7607
(914) 470-5056
Mailing address
1265 CLOVE RD, STATEN ISLAND, NY 10301-4339
(973) 493-7607
(914) 470-5056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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