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Mudassir Mumtaz, MD
Student in an Organized Health Care Education/Training Program in Port Jefferson, New York
NPI 1639755218

Mudassir Mumtaz is a Student in an Organized Health Care Education/Training Program based in Port Jefferson, NY. Mudassir Mumtaz practices in Port Jefferson, NY and has the professional credentials of MD. The NPI Number for Mudassir Mumtaz is 1639755218 and holds a License No. (New York).

The current practice location address for Mudassir Mumtaz is 75 N Country Rd, Port Jefferson, NY and can be reached out via phone at 631-686-2549.

Location: 75 N Country Rd, Port Jefferson, NY, 11777-2190
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639755218
Provider Name
Mudassir Mumtaz
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
75 N Country Rd, Port Jefferson, NY, 11777-2190
Phone Number
631-686-2549
Fax Number
Provider Enumeration Date
03/23/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
75 N Country Rd
City
Port Jefferson
State
New York
Zip
11777-2190
Phone Number
631-686-2549
Fax Number
person
Provider Business Mailing Address Details
Address
75 N Country Rd
City
Port Jefferson
State
New York
Zip
11777-2190
Phone Number
631-686-2549
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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