Basic Information
| Provider Information | |||||||||
| NPI: | 1427095017 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOGAR | ||||||||
| FirstName: | MUKUND | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX A | ||||||||
| Address2: | ASSURE ANESTHESIA | ||||||||
| City: | NORTH BELLMORE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117100745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007201664 | ||||||||
| FaxNumber: | 2077532020 | ||||||||
| Practice Location | |||||||||
| Address1: | 2475 SAINT RAYMONDS AVE | ||||||||
| Address2: | ANESTHESIA DEPARTMENT | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104613124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184307473 | ||||||||
| FaxNumber: | 7184307336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 11/07/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 190862 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | P00154660 | 01 | RAILROAD MEDICARE | OTHER | 01413441 | 05 | NY | MEDICAID |