Provider Demographics
NPI:1275172447
Name:KAMAL, SHOWAIB HASAN
Entity Type:Individual
Prefix:
First Name:SHOWAIB
Middle Name:HASAN
Last Name:KAMAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8280 167TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1823
Mailing Address - Country:US
Mailing Address - Phone:347-603-4344
Mailing Address - Fax:
Practice Address - Street 1:8280 167TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1823
Practice Address - Country:US
Practice Address - Phone:347-603-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant