Mustafa Ansari, RN

Individual provider Active NPI Medical-Surgical Registered Nurse · Johnson City, NY

NPI 1083395644 · NPPES record last updated Jul 27, 2023

Key facts

NPI
1083395644
Entity type
Individual (NPI type 1)
Primary specialty
Medical-Surgical Registered Nurse 163WM0705X
License
752568 (NY)
Practice address
1108 Anna Maria Dr
Johnson City, NY 13790-5007
Phone
(607) 232-0525
NPI assigned
Jul 27, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
752568NYMDMedical-Surgical Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 752568 NY Yes

Addresses

Primary practice location

1108 Anna Maria Dr
Johnson City, NY 13790-5007

Mailing address

1108 Anna Maria Dr
Johnson City, NY 13790-5007
Phone (607) 232-0525

Other providers in Johnson City, NY

All providers in Johnson City, NY · Medical-Surgical Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.