Provider Demographics
NPI:1851597470
Name:MUNIR, AFFAF (MD)
Entity type:Individual
Prefix:
First Name:AFFAF
Middle Name:
Last Name:MUNIR
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 1:111 HOSPITAL DR
Mailing Address - Street 2:ATTN: CREDENTIALING DEPT
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502
Mailing Address - Country:US
Mailing Address - Phone:315-801-8534
Mailing Address - Fax:315-801-8391
Practice Address - Street 1:37 MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:NY
Practice Address - Zip Code:13492-1034
Practice Address - Country:US
Practice Address - Phone:315-624-8800
Practice Address - Fax:315-624-8810
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY258048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03245214Medicaid
NYP00942527OtherRRMCR
NY03245214Medicaid