Provider Demographics
NPI:1164109021
Name:NAHAR, SHAMSUN (MD)
Entity Type:Individual
Prefix:
First Name:SHAMSUN
Middle Name:
Last Name:NAHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 FORT HILL TER APT 15
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4254
Mailing Address - Country:US
Mailing Address - Phone:716-235-6223
Mailing Address - Fax:
Practice Address - Street 1:989 BLOSSOM RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-2251
Practice Address - Country:US
Practice Address - Phone:585-482-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-P122564-01207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine