Individual
DR. CHOUDHURY MANJURUL HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D FACC, FCCP,FSACI
Contact information
Practice address
8405 169TH ST, JAMAICA, NY 11432-2033
(718) 657-8001
(718) 732-0783
Mailing address
8405 169TH ST, JAMAICA, NY 11432-2033
(718) 657-8001
(718) 732-0783
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
193570
NY
207RI0011X
Interventional Cardiology Physician
193570
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01878124
—
NY
Enumeration date
12/28/2005
Last updated
09/25/2007
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