Doctor Name: | DR. AMIRA MANTOURA |
NPI Number: | 1700801610 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPM |
License Number: | 000430 |
Business Practice Address: | 95 Morgan St Suite 1j Stamford, CT - 069055474 |
Business Phone Number: | 2039751175 |
Business Fax Number: | 2039780641 |
Mailing Address: | 95 Morgan St, Suite 1j STAMFORD |
State: | CT |
Postal Code: | 069055474 |
Phone Number: | 2039751175 |
Fax Number: | 2039780641 |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 01/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 000430 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |