Provider Demographics
NPI:1346668712
Name:MOHAMMED, ABDUL-RAZAK (FNP)
Entity Type:Individual
Prefix:MR
First Name:ABDUL-RAZAK
Middle Name:
Last Name:MOHAMMED
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:MR
Other - First Name:ABDUL-RAZAK
Other - Middle Name:
Other - Last Name:MOHAMMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1434 OGDEN AVE
Mailing Address - Street 2:APT 6Q
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-2341
Mailing Address - Country:US
Mailing Address - Phone:646-670-8626
Mailing Address - Fax:
Practice Address - Street 1:506 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-1620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338657261Q00000X
NY338657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center