Provider Demographics
NPI:1598784753
Name:KASHEM, ABUL (MD)
Entity Type:Individual
Prefix:
First Name:ABUL
Middle Name:
Last Name:KASHEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 148TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-1433
Mailing Address - Country:US
Mailing Address - Phone:917-306-8073
Mailing Address - Fax:
Practice Address - Street 1:2512 148TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1433
Practice Address - Country:US
Practice Address - Phone:717-716-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002147207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02584614Medicaid
NY9L1851Medicare ID - Type Unspecified
NY02584614Medicaid