Individual
ANIS MANSUR MOH RAMALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8742 ELMHURST AVE APT 3C, ELMHURST, NY 11373-2511
(347) 393-2141
Mailing address
8742 ELMHURST AVE APT 3C, ELMHURST, NY 11373-2511
(347) 393-2141
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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