Individual
DR. FAZLE SHOWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 BROADHOLLOW RD STE 106, FARMINGDALE, NY 11735-4813
(631) 693-6644
Mailing address
100 BROADHOLLOW RD STE 106, FARMINGDALE, NY 11735-4813
(631) 693-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
321826
NY
208D00000X
General Practice Physician
321826
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2021
Last updated
02/10/2025
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