Provider Demographics
NPI:1902023211
Name:MANSOOR, ATHER (MD, MHA)
Entity Type:Individual
Prefix:DR
First Name:ATHER
Middle Name:
Last Name:MANSOOR
Suffix:
Gender:M
Credentials:MD, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-5054
Mailing Address - Country:US
Mailing Address - Phone:610-628-8038
Mailing Address - Fax:866-736-5965
Practice Address - Street 1:1648 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-5054
Practice Address - Country:US
Practice Address - Phone:610-628-8038
Practice Address - Fax:866-736-5965
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245174207R00000X
PAMT184886207RC0000X
PAMD433394207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine