Provider Demographics
NPI:1689008211
Name:BEGUM, FERDOUSI (FNP)
Entity Type:Individual
Prefix:
First Name:FERDOUSI
Middle Name:
Last Name:BEGUM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7035 BROADWAY APT D11
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6109
Mailing Address - Country:US
Mailing Address - Phone:917-815-6491
Mailing Address - Fax:718-433-9445
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2343
Practice Address - Fax:718-334-5006
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY403606363LP0808X
NY338122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health