Healthcare Provider Details

I. General information

NPI: 1174542575
Provider Name (Legal Business Name): TAMANNA NAHAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13421 SPRINGFIELD BLVD
SPRINGFIELD GARDENS NY
11413-1448
US

IV. Provider business mailing address

82 JOHNSON AVE
ENGLEWOOD CLIFFS NJ
07632-2201
US

V. Phone/Fax

Practice location:
  • Phone: 668-265-8888
  • Fax:
Mailing address:
  • Phone: 201-314-7922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA07693700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME118111
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MAO7693700
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number49852
License Number StateKY
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number193779
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: