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General NPI Number Information
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NPI Number | 1700241023
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Entity Type | Individual
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Provider Name | NAZMUL NAYEEM PA
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Gender | Male
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Dates
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Enumeration Date | 12/31/2015
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 172-17 JAMAICA AVENUE
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City | JAMAICA
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State | NY
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Zip | 11432-4134
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Country | US
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Telephone | 347-692-4587
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Fax |
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Provider Business Mailing Address
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Address Line | 17217 JAMAICA AVE
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City | JAMAICA
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State | NY
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Zip | 11432-5562
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Country | US
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Telephone | 347-692-4587
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 000200
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License Number State | NY
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