Provider Demographics
NPI:1336640333
Name:ZOHRA, MOBEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:MOBEEN
Middle Name:
Last Name:ZOHRA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STONY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1053
Mailing Address - Country:US
Mailing Address - Phone:203-408-6409
Mailing Address - Fax:
Practice Address - Street 1:2101 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7761
Practice Address - Country:US
Practice Address - Phone:336-875-6575
Practice Address - Fax:336-781-0073
Is Sole Proprietor?:No
Enumeration Date:2018-02-24
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021773363A00000X
NC10-09613363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant