Provider Demographics
NPI:1164424552
Name:MOHAMED, NAUREEN ABUBAKER (MD)
Entity Type:Individual
Prefix:DR
First Name:NAUREEN
Middle Name:ABUBAKER
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5820 MAIN ST
Mailing Address - Street 2:SUITE 314
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5776
Mailing Address - Country:US
Mailing Address - Phone:716-633-3323
Mailing Address - Fax:716-633-3323
Practice Address - Street 1:5820 MAIN ST
Practice Address - Street 2:SUITE 314
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5776
Practice Address - Country:US
Practice Address - Phone:716-633-3323
Practice Address - Fax:716-633-3323
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY211966-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02080835Medicaid
H13290Medicare UPIN
NYIA0494Medicare ID - Type Unspecified