Healthcare Provider Details

I. General information

NPI: 1831027002
Provider Name (Legal Business Name): JUNNATUL FERDOUSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 BEACH 48TH ST
FAR ROCKAWAY NY
11691-1120
US

IV. Provider business mailing address

8375 117TH ST APT 5E
RICHMOND HILL NY
11418-1424
US

V. Phone/Fax

Practice location:
  • Phone: 718-471-5000
  • Fax:
Mailing address:
  • Phone: 531-344-9311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP141784
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: