Park Place Medical P.C.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

191343 Issued in NY

Legal business name

PARK PLACE MEDICAL P.C.

Practice address

2912 210TH PL
Bayside, NY 11360-2433

Phone

(718) 773-2011

Fax

(718) 773-3728

NPI assigned

Nov 8, 2007

Last updated

Nov 8, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohammed Mansour, M.D.

Title

President

Phone

(718) 773-2011

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohamed Mansour

  • Gastroenterology Physician
  • Bayside, NY
  • NPI 1003848854
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1932389731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 PARK PL",
            "address_2": "SUITE 1-B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112164000",
            "telephone_number": "718-773-2011",
            "fax_number": "718-773-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 210TH PL",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602433",
            "telephone_number": "718-773-2011",
            "fax_number": "718-773-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-773-2011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "191343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Despina Pappas, DDS
• Elayne S Pappas, DDS
• Frank John Pappas, DDS
• Paradigm Neurological Services, PC
• Suneel V Parikh, MD
• Chan Jin Park, L.AC
• Chun Hyung Park, DC
• Haeyoung Park
• Janice E Park, LCSW
• Jayoung Park

• Gastroenterology Physician in Bayside, NY
• Providers in Bayside, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.