Provider Demographics
NPI:1285301804
Name:MOHAMMED MORSY, HAMDY TALAAT
Entity type:Individual
Prefix:
First Name:HAMDY
Middle Name:TALAAT
Last Name:MOHAMMED MORSY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KIMBALL CT APT 406
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6969
Mailing Address - Country:US
Mailing Address - Phone:917-705-4586
Mailing Address - Fax:
Practice Address - Street 1:341 SUMMER ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-3141
Practice Address - Country:US
Practice Address - Phone:617-625-9400
Practice Address - Fax:617-625-9401
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist