Provider Demographics
NPI:1972503480
Name:JAHANGIR, ABDUL K (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:K
Last Name:JAHANGIR
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 1:1435 86TH STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228
Mailing Address - Country:US
Mailing Address - Phone:718-238-6100
Mailing Address - Fax:718-680-7969
Practice Address - Street 1:1435 86TH STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228
Practice Address - Country:US
Practice Address - Phone:718-238-6100
Practice Address - Fax:718-680-7969
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2013-02-13
Deactivation Date:2006-04-06
Deactivation Code:
Reactivation Date:2006-04-07
Provider Licenses
StateLicense IDTaxonomies
NY147085208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
165283OtherELERPLAN
NY00834253Medicaid
147085OtherHIP
149355OtherWELLCARE
6051980OtherFIDELIS
02N1021OtherNEIGHBORHOOD
BK00310.01OtherAMERICHOICE
0045684OtherAETNA
NY008342538Medicaid
0100696OtherGHI
2C7176OtherHEALTH NET
KS249OtherOXFORD
147085OtherHIP
NYB11256Medicare UPIN
23D541Medicare ID - Type Unspecified