Provider Demographics
NPI:1881211985
Name:ABDUL GHAYUM, MOHAMED AASHIQ (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED AASHIQ
Middle Name:
Last Name:ABDUL GHAYUM
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:BRONX-LEBANON HOSPITAL CENTER
Mailing Address - Street 2:1650 GRAND CONCOURSE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-960-1449
Mailing Address - Fax:
Practice Address - Street 1:BRONX-LEBANON HOSPITAL CENTER
Practice Address - Street 2:1650 GRAND CONCOURSE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-960-1449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program