Provider Demographics
NPI:1750556239
Name:BEGUM, MONOWARA (MD)
Entity type:Individual
Prefix:
First Name:MONOWARA
Middle Name:
Last Name:BEGUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-1619
Mailing Address - Country:US
Mailing Address - Phone:845-359-7804
Mailing Address - Fax:
Practice Address - Street 1:48 S CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-1619
Practice Address - Country:US
Practice Address - Phone:845-359-7804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153407204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01557006Medicaid
NYF27674Medicare UPIN
NY01557006Medicaid