Provider Demographics
NPI:1053312645
Name:ABDULLAH, MUHAMMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:
Last Name:ABDULLAH
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 1:244 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2103
Mailing Address - Country:US
Mailing Address - Phone:718-552-6596
Mailing Address - Fax:718-972-5598
Practice Address - Street 1:244 72ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2103
Practice Address - Country:US
Practice Address - Phone:718-552-6596
Practice Address - Fax:718-972-5598
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218807207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02105842Medicaid
NYOV 0021Medicare ID - Type Unspecified
NY02105842Medicaid