Provider Demographics
NPI:1386404648
Name:MOHAMED, TROY ISA (MD)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:ISA
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FARRAH
Other - Middle Name:
Other - Last Name:MOHAMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:750 ALBANY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2520
Mailing Address - Country:US
Mailing Address - Phone:617-638-6975
Mailing Address - Fax:
Practice Address - Street 1:750 ALBANY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2520
Practice Address - Country:US
Practice Address - Phone:617-638-6975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program