Provider Demographics
NPI:1912951641
Name:MROUEH, LAMIA MAHHOUD (MD)
Entity Type:Individual
Prefix:
First Name:LAMIA
Middle Name:MAHHOUD
Last Name:MROUEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 68TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-6004
Mailing Address - Country:US
Mailing Address - Phone:718-680-9387
Mailing Address - Fax:
Practice Address - Street 1:6209 16TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-2702
Practice Address - Country:US
Practice Address - Phone:718-234-0073
Practice Address - Fax:718-236-8456
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG94174Medicare ID - Type Unspecified