National Provider Identifier
Mamdouh Ezzat Ibrahim
Mamdouh Ezzat Ibrahim is listed in the NPPES registry with a primary specialty of Taxi in Fairport, NY and a listed phone number of (315) 744-7674.
Profile Overview
- NPI
- 1841959285
- Provider Type
- Individual
- Primary Specialty
- Taxi
- Enumeration Date
- December 13, 2021
- Last Updated
- December 13, 2021
Practice Location
- 211 Moseley RD
- Fairport, NY 14450-3060
Phone: (315) 744-7674
Specialties
- Taxi (344600000X)
- Driver (172A00000X)
Full Record
- NPI
- 1841959285
- Entity Type
- Individual
- Last Name
- Ibrahim
- First Name
- Mamdouh
- Middle Name
- Ezzat
- Name Prefix
- Mr.
- Mailing Street Address
- 211 Moseley RD
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-3060
- Mailing Country
- US
- Mailing Phone
- (315) 744-7674
- Practice Street Address
- 211 Moseley RD
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-3060
- Practice Country
- US
- Practice Phone
- (315) 744-7674
- Enumeration Date
- December 13, 2021
- Last Updated
- December 13, 2021
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- December 13, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Taxi (344600000X), Driver (172A00000X)
- Other Identifiers
- 06779419 (NY)