National Provider Identifier
Mutasim Idriss, MD
Mutasim Idriss, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Rochester, NY and a listed phone number of (585) 368-4800.
Profile Overview
- NPI
- 1760168157
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- June 22, 2023
- Last Updated
- June 22, 2023
Practice Location
- 1561 Long Pond RD Ste 206
- Rochester, NY 14626-4135
Phone: (585) 368-4800
Mailing Address
- 1555 Long Pond RD
- Rochester, NY 14626-4164
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1760168157
- Entity Type
- Individual
- Last Name
- Idriss
- First Name
- Mutasim
- Credential
- MD
- Mailing Street Address
- 1555 Long Pond RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14626-4164
- Mailing Country
- US
- Mailing Phone
- (585) 723-7746
- Mailing Fax
- (585) 723-7834
- Practice Street Address
- 1561 Long Pond RD Ste 206
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14626-4135
- Practice Country
- US
- Practice Phone
- (585) 368-4800
- Practice Fax
- (585) 368-4815
- Enumeration Date
- June 22, 2023
- Last Updated
- June 22, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- June 22, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)