Healthcare Provider Details

I. General information

NPI: 1346697315
Provider Name (Legal Business Name): FATHIMA FAHMIDHA JAHUFAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 210TH ST 111 E 210TH ST
BRONX NY
10467-2401
US

IV. Provider business mailing address

111 E 210TH ST MONTEFIORE MEDICAL CENTER
BRONX NY
10467-2401
US

V. Phone/Fax

Practice location:
  • Phone: 718-405-8040
  • Fax:
Mailing address:
  • Phone: 508-250-6699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number118774719
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: