Al-Mansour, Mazen Rafique
Al-Mansour, Mazen Rafique is an individual health care provider with primary practice located at 2 Medical Center Drive Suite 308, Springfield MA 01107-1270. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Al-Mansour, Mazen Rafique can be contacted via phone (413) 794-7020.Contact Information
Primary practice address
2 Medical Center Drive Suite 308
Springfield MA 01107-1270
Phone: (413) 794-7020
Fax: (413) 794-2670
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ME144439 | Florida |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 250915 | Massachusetts |
Profile Details
| NPI number | 1316146756 |
|---|---|
| LBN Legal business name | Al-Mansour, Mazen Rafique |
| Credentials | M.B.B.S |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 16th, 2007 |
| Last updated | Mar 5th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316146756 | NPPES |
| Massachusetts | MEDICAID | 110093025/A | |
| Massachusetts | Other | P01701404 | |
| Massachusetts | MEDICAID | 0171953 |
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