Individual
IBTHEESAM ZAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4032 74TH ST, ELMHURST, NY 11373-5628
(718) 424-0200
Mailing address
7035 BROADWAY APT A8, JACKSON HEIGHTS, NY 11372-6104
(347) 684-0806
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309943
NY
Other
Enumeration date
10/03/2020
Last updated
10/03/2020
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