Provider Demographics
NPI:1821469545
Name:MANSOUR, ELHUSSIEN SABER
Entity Type:Individual
Prefix:MR
First Name:ELHUSSIEN
Middle Name:SABER
Last Name:MANSOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 OSBORNE COURT
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14303
Mailing Address - Country:US
Mailing Address - Phone:716-236-7355
Mailing Address - Fax:
Practice Address - Street 1:1424 OSBORNE CT
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14303-1629
Practice Address - Country:US
Practice Address - Phone:716-251-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)