Jamak Mohitiasli
Nurse Practitioner, Family in New York, NY. Individual provider (NPI-1).
NPI number1568898377
StatusActive
Last updated in NPPESJun 9, 2014
Details
- NPI
- 1568898377
- Entity type
- Individual (NPI-1)
- Name
- Jamak Mohitiasli
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 25, 2013
- Last updated
- Jun 9, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F337893-1 | NY | Yes |
Practice location
1 Gustave L Lavy PlaceNew York, NY 10029
Phone 212-241-7944
Mailing address
1 Gustave L Lavy PlaceNew York, NY 10029
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