Provider Demographics
NPI:1558028845
Name:MAZUMDER, UMNA (DC)
Entity Type:Individual
Prefix:
First Name:UMNA
Middle Name:
Last Name:MAZUMDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 77TH ST APT 408
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-2303
Mailing Address - Country:US
Mailing Address - Phone:917-757-0315
Mailing Address - Fax:
Practice Address - Street 1:3421 77TH ST APT 408
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-2303
Practice Address - Country:US
Practice Address - Phone:917-757-0315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor