Provider Demographics
NPI:1427670710
Name:MAMOOR, ROBYNA (DDS)
Entity type:Individual
Prefix:
First Name:ROBYNA
Middle Name:
Last Name:MAMOOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 EVERDELL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4215
Mailing Address - Country:US
Mailing Address - Phone:516-356-8355
Mailing Address - Fax:
Practice Address - Street 1:422 EVERDELL AVE
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4215
Practice Address - Country:US
Practice Address - Phone:516-356-8355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program