Provider Demographics
NPI:1619250925
Name:MUNDIA, MUBASIR (MD)
Entity type:Individual
Prefix:DR
First Name:MUBASIR
Middle Name:
Last Name:MUNDIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5443
Mailing Address - Country:US
Mailing Address - Phone:516-632-3353
Mailing Address - Fax:516-632-3397
Practice Address - Street 1:1 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5443
Practice Address - Country:US
Practice Address - Phone:516-632-3353
Practice Address - Fax:516-632-3397
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251024207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology