Provider Demographics
NPI:1578236832
Name:BEGUM, EASMIN NAHER (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:EASMIN
Middle Name:NAHER
Last Name:BEGUM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 SELLECK ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-6322
Mailing Address - Country:US
Mailing Address - Phone:203-550-4075
Mailing Address - Fax:
Practice Address - Street 1:81 HOLLY HILL LN
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6071
Practice Address - Country:US
Practice Address - Phone:203-550-4075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-31
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5423363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant