Provider Demographics
NPI:1639695919
Name:MONIR, MUCHAMMAT NAZMEN
Entity Type:Individual
Prefix:
First Name:MUCHAMMAT
Middle Name:NAZMEN
Last Name:MONIR
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 1:6823 5TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-6009
Mailing Address - Country:US
Mailing Address - Phone:718-253-4477
Mailing Address - Fax:718-253-0545
Practice Address - Street 1:6823 5TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-6009
Practice Address - Country:US
Practice Address - Phone:718-253-4477
Practice Address - Fax:718-253-0545
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation