Provider Demographics
NPI:1699201012
Name:MAJUMDER, MD MASHIUR RAHMAN (PA)
Entity Type:Individual
Prefix:
First Name:MD
Middle Name:MASHIUR RAHMAN
Last Name:MAJUMDER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 VALENTINE AVE
Mailing Address - Street 2:APT 5C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-2627
Mailing Address - Country:US
Mailing Address - Phone:917-725-0067
Mailing Address - Fax:
Practice Address - Street 1:2668 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2630
Practice Address - Country:US
Practice Address - Phone:917-725-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020828363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant