Provider Demographics
NPI:1104449487
Name:MOUSA KAMEL, ERENY (DPM)
Entity type:Individual
Prefix:
First Name:ERENY
Middle Name:
Last Name:MOUSA KAMEL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990A LEXINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2911
Mailing Address - Country:US
Mailing Address - Phone:212-534-5009
Mailing Address - Fax:212-257-7007
Practice Address - Street 1:1990A LEXINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2911
Practice Address - Country:US
Practice Address - Phone:212-534-5009
Practice Address - Fax:212-257-7007
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NYN007348213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program