Healthcare Provider Details

I. General information

NPI: 1750228474
Provider Name (Legal Business Name): LUQMAN AHMED BANDAGI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 S OHIO AVE
ATLANTIC CITY NJ
08401-6711
US

IV. Provider business mailing address

41 CHENANGO DR
JERICHO NY
11753-1503
US

V. Phone/Fax

Practice location:
  • Phone: 609-441-8074
  • Fax:
Mailing address:
  • Phone: 917-583-6462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: