Mia, Mohammad

Mia, Mohammad is an sole proprietor health care provider with primary practice located at 4018 Case St , Elmhurst NY 11373-1614. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mia, Mohammad can be contacted via phone (718) 639-6980.

Contact Information

Primary practice address
4018 Case St Elmhurst NY 11373-1614
Phone: (718) 639-6980
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 36334 New York

Profile Details

NPI number 1992795637
LBN Legal business name Mia, Mohammad
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2005
Last updated Jun 21st, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992795637 NPPES
New York MEDICAID 00709664

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