Provider Demographics
NPI:1245414325
Name:QUAYUM, ABM NAZIRUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABM
Middle Name:NAZIRUL
Last Name:QUAYUM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8432 106TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1137
Mailing Address - Country:US
Mailing Address - Phone:917-375-1026
Mailing Address - Fax:
Practice Address - Street 1:3640 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6521
Practice Address - Country:US
Practice Address - Phone:718-888-9839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039697122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist