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NPI Code Detail

MEDICARE: DR. MOHAMMED JAHANGIR ALAM M.D.

MEDICARE: DR. MOHAMMED JAHANGIR ALAM M.D.
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician217943NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1217943OTHERNYNYS LICENSE

General Provider Information

NPI Number : 1730264441
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMMED JAHANGIR ALAM M.D.
Provider Business Mailing Address
First Line : 100 PATRIOTS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3318
Country : US
Telephone Number : 631-444-8608
Fax Number : 631-444-8778
Provider Business Practice Location Address
First Line : 100 PATRIOTS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3318
Country : US
Telephone Number : 631-444-8608
Fax Number : 631-444-8778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 05/21/2023

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