MEDICARE: S.K. BHUIYAN PHYSICIAN, PC

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	207W00000X	Ophthalmology Physician	206889-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588752752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S.K. BHUIYAN PHYSICIAN, PC

Provider Business Mailing Address
First Line	:	1100 SHAMES DR
Second Line	:	SUITE 100
City	:	WESTBURY
State	:	NY
Zip	:	11590-1765
Country	:	US
Telephone Number	:	516-693-0700
Fax Number	:	516-693-0271

Provider Business Practice Location Address
First Line	:	4024 76TH ST STE 1AB
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1009
Country	:	US
Telephone Number	:	718-812-7866
Fax Number	:	516-706-6026

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	DR. MUHAMMAD MOMEN
Credential	:
Telephone Number	:	718-200-0723

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	11/26/2023

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