Individual
KHADEZA YESMIN UDDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-2000
Mailing address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-2000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
025610
NY
363A00000X
Physician Assistant
025610
NY
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/25/2020
Last updated
12/22/2021
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