Doctor Name: | DR. RINDA MOUSA |
NPI Number: | 1043664675 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | P01459 |
Business Practice Address: | 1160 Teller Ave Bronx, NY - 104564145 |
Business Phone Number: | 7182931500 |
Business Fax Number: | 7189927074 |
Mailing Address: | 3198 Grand Concourse, BRONX |
State: | NY |
Postal Code: | 104581000 |
Phone Number: | 7186180401 |
Fax Number: | 7187954394 |
NPI Enumeration Date: | 04/20/2016 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | P01459 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |