MEDICARE: UMNA MAZUMDER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X013528	NY

General Provider Information

NPI Number	:	1558028845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UMNA MAZUMDER DC

Provider Business Mailing Address
First Line	:	3421 77TH ST APT 408
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-2303
Country	:	US
Telephone Number	:	917-757-0315
Fax Number	:

Provider Business Practice Location Address
First Line	:	3421 77TH ST APT 408
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-2303
Country	:	US
Telephone Number	:	917-757-0315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2021
Last Update Date	:	11/21/2021

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