Organization
PARK PLACE MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED MANSOUR M.D. (PRESIDENT)
(718) 773-2011
Entity
Organization
Contact information
Practice address
2912 210TH PL, BAYSIDE, NY 11360-2433
(718) 773-2011
(718) 773-3728
Mailing address
910 PARK PL, SUITE 1-B, BROOKLYN, NY 11216-4000
(718) 773-2011
(718) 773-3728
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
191343
NY
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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