MEDICARE: MRS. TAHMINA MOJUMDER

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	363LG0600X	Gerontology Nurse Practitioner	26NJ15469800	NJ

General Provider Information

NPI Number	:	1992669311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAHMINA MOJUMDER

Provider Business Mailing Address
First Line	:	22 GENESSEE AVE APT 2
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07503-1449
Country	:	US
Telephone Number	:	973-914-1443
Fax Number	:

Provider Business Practice Location Address
First Line	:	2035 HAMBURG TPKE STE B
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-6251
Country	:	US
Telephone Number	:	862-347-4058
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/16/2025

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