Individual
SIMUKAYI MUTASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, PB-1-301, NEW YORK, NY 10032-3720
(212) 305-4928
(212) 305-8177
Mailing address
622 WEST 168TH STREET, PB-1-301 NYPH:, NEW YORK, NY 10032
(212) 305-4928
(212) 305-8177
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
289620
NY
2085R0202X
Diagnostic Radiology Physician
BP10054934
TX
2085R0202X
Diagnostic Radiology Physician
Primary
MD469950
PA
Other
Enumeration date
04/07/2015
Last updated
11/14/2024
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