Provider Demographics
NPI:1477197416
Name:BEGUM, BIBI
Entity Type:Individual
Prefix:
First Name:BIBI
Middle Name:
Last Name:BEGUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 BEVERLEY RD FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3316
Mailing Address - Country:US
Mailing Address - Phone:646-240-3514
Mailing Address - Fax:
Practice Address - Street 1:160 CONVENT AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-9101
Practice Address - Country:US
Practice Address - Phone:212-650-7745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program