Healthcare Provider Details

I. General information

NPI: 1457272205
Provider Name (Legal Business Name): JARIN TASNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 FROST LN UNIT A
LAWRENCE NY
11559-1806
US

IV. Provider business mailing address

7905 S WHEELING AVE APT 42P
TULSA OK
74136-8633
US

V. Phone/Fax

Practice location:
  • Phone: 917-776-6823
  • Fax:
Mailing address:
  • Phone: 539-240-8258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP142278
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: