Provider Demographics
NPI:1033437827
Name:SHIBLEE, TOWHID HOSSAIN (MD)
Entity Type:Individual
Prefix:
First Name:TOWHID
Middle Name:HOSSAIN
Last Name:SHIBLEE
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 1:3730 73RD ST STE PQ
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6233
Mailing Address - Country:US
Mailing Address - Phone:718-247-7340
Mailing Address - Fax:718-532-9732
Practice Address - Street 1:3730 73RD ST STE PQ
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6233
Practice Address - Country:US
Practice Address - Phone:718-247-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256963207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03452802Medicaid
NYA400069657Medicare PIN