Provider Demographics
NPI:1396804910
Name:DURRANI, MOHAMED SOHAIL (MD)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:SOHAIL
Last Name:DURRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:M
Other - Middle Name:S
Other - Last Name:DURRANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:222 RED SCHOOL LN
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865
Practice Address - Country:US
Practice Address - Phone:908-760-3203
Practice Address - Fax:908-760-3204
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035736L207R00000X
NJ25MA03223800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
03025600OtherCAPITAL
442613270OtherRAILROAD MEDICARE
NJ2910802Medicaid
4250739OtherAETNA
PAMR060661872OtherHGS MEDICARE
0089847001OtherAMERIHEALTH HMO
OK4845OtherHEATLHNET
442613270OtherRAILROAD MEDICARE
NJ178269Medicare ID - Type Unspecified