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General NPI Number Information
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NPI Number | 1558604413
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Entity Type | Individual
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Provider Name | FATEMAH MAMDANI MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 622 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 201-776-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 28 WELLWOOD RD
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City | DEMAREST
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State | NJ
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Zip | 07627-1215
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Country | US
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Telephone | 201-776-0585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | 25MA10363500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | 291305-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 291305-01
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA10363500
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License Number State | NJ
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