Provider Demographics
NPI:1699747063
Name:CHEEMA, MOHSIN MAQBOOL (MD)
Entity type:Individual
Prefix:DR
First Name:MOHSIN
Middle Name:MAQBOOL
Last Name:CHEEMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 HURLEY AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-2810
Mailing Address - Country:US
Mailing Address - Phone:845-339-4500
Mailing Address - Fax:845-339-9500
Practice Address - Street 1:84 HURLEY AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2810
Practice Address - Country:US
Practice Address - Phone:845-339-4500
Practice Address - Fax:845-339-9500
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200754207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01856371Medicaid
NY95T501Medicare ID - Type Unspecified
NY01856371Medicaid