Healthcare Provider Details

I. General information

NPI: 1043454044
Provider Name (Legal Business Name): MOHAMMED SHAMSUZ ZAMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2009
Last Update Date: 05/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 SKOKORAT ST
SEYMOUR CT
06483-3826
US

IV. Provider business mailing address

43 SKOKORAT ST
SEYMOUR CT
06483-3826
US

V. Phone/Fax

Practice location:
  • Phone: 201-654-6397
  • Fax: 407-602-0795
Mailing address:
  • Phone:
  • Fax: 407-602-0795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number281993
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number54937
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: