Provider Demographics
NPI:1619473915
Name:BHUIYAN, SAKIL AMIN (MD)
Entity Type:Individual
Prefix:
First Name:SAKIL
Middle Name:AMIN
Last Name:BHUIYAN
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 1:2158 ATLANTIC AVE APT 4F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4105
Mailing Address - Country:US
Mailing Address - Phone:631-507-4864
Mailing Address - Fax:
Practice Address - Street 1:2158 ATLANTIC AVE APT 4F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-4105
Practice Address - Country:US
Practice Address - Phone:631-507-4864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program