Individual
FATEMA T ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
599 FARMINGTON AVE, FARMINGTON, CT 06032-2381
(860) 284-4945
Mailing address
321 E ALBANY ST, HERKIMER, NY 13350-2016
(315) 867-2700
(315) 867-2799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
237529
NY
207Q00000X
Family Medicine Physician
Primary
72102
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237529
DOH
NY
05
—
237529
—
NY
Enumeration date
09/15/2006
Last updated
03/07/2023
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