Individual
MR. ATHAR MUJTABA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
10426 ROOSEVELT AVE, CORONA, NY 11368
(718) 533-0991
(833) 969-0190
Mailing address
10426 ROOSEVELT AVE, CORONA, NY 11368
(718) 533-0991
(833) 969-0190
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
344517
NY
Other
Enumeration date
06/17/2019
Last updated
01/15/2021
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