Healthcare Provider Details

I. General information

NPI: 1528948593
Provider Name (Legal Business Name): MEHJABIN ALAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 FRONT ST
HEMPSTEAD NY
11550-4600
US

IV. Provider business mailing address

18423 N CONDUIT AVE
SPRINGFIELD GARDENS NY
11413-3233
US

V. Phone/Fax

Practice location:
  • Phone: 516-705-9700
  • Fax:
Mailing address:
  • Phone: 929-342-9986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP136811
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: