Provider Demographics
NPI:1184785263
Name:MOHAMMED S NIZAM M D
Entity type:Organization
Organization Name:MOHAMMED S NIZAM M D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:S
Authorized Official - Last Name:NIZAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-861-1400
Mailing Address - Street 1:950 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0320
Mailing Address - Country:US
Mailing Address - Phone:212-861-1400
Mailing Address - Fax:
Practice Address - Street 1:950 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0320
Practice Address - Country:US
Practice Address - Phone:212-861-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty