Healthcare Provider Details

I. General information

NPI: 1356202188
Provider Name (Legal Business Name): IMRAN MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19622 HILLSIDE AVE
HOLLIS NY
11423-2050
US

IV. Provider business mailing address

14 CAPRI DR
ROSLYN NY
11576-3205
US

V. Phone/Fax

Practice location:
  • Phone: 917-399-2374
  • Fax: 718-480-6652
Mailing address:
  • Phone: 347-390-0612
  • Fax: 718-480-6652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHD HOSSAIN
Title or Position: MD
Credential: MD
Phone: 917-399-2374