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Individual

MOHAMMED QAMRUL ISLAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
40-27, 74TH STREET, ELMHURST, NY 11040-2505
(718) 424-1300
(718) 424-1311
Mailing address
4027 74TH ST, ELMHURST, NY 11373-5603
(718) 424-1300
(718) 883-1311

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
248033
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A100092321
MEDICARE GROUP
NY
01
A400092328
MEDICARE
NY
Enumeration date
02/23/2006
Last updated
07/15/2015
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