Provider Demographics
NPI:1013198886
Name:HASHMI, IMADUDDIN SYED (MD)
Entity Type:Individual
Prefix:DR
First Name:IMADUDDIN
Middle Name:SYED
Last Name:HASHMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2605
Mailing Address - Country:US
Mailing Address - Phone:718-306-5025
Mailing Address - Fax:718-306-5065
Practice Address - Street 1:427 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2605
Practice Address - Country:US
Practice Address - Phone:718-306-5025
Practice Address - Fax:718-306-5065
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01359457Medicaid
NY01359457Medicaid