Basic Information
| Provider Information | |||||||||
| NPI: | 1053318576 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAAS | ||||||||
| FirstName: | MAMOON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 14890 | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122124890 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185255634 | ||||||||
| FaxNumber: | 5186494094 | ||||||||
| Practice Location | |||||||||
| Address1: | 326 S PEARL ST | ||||||||
| Address2: | ST. PETER'S HOSPITAL FAMILY HEALTH CENTER | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122021914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184490100 | ||||||||
| FaxNumber: | 5184638580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 05/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 211266 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207ZP0102X | 211266 | NY | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207Q00000X | 211266 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.