Provider Demographics
NPI:1841350360
Name:MAHMUD-THIAM, UMAIMAH (CM)
Entity type:Individual
Prefix:MS
First Name:UMAIMAH
Middle Name:
Last Name:MAHMUD-THIAM
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:88 LEXINGTON AVE
Mailing Address - Street 2:APT 1LEFT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1444
Mailing Address - Country:US
Mailing Address - Phone:347-414-4247
Mailing Address - Fax:718-989-4877
Practice Address - Street 1:88 LEXINGTON AVE
Practice Address - Street 2:APT 1LEFT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-1444
Practice Address - Country:US
Practice Address - Phone:347-414-4247
Practice Address - Fax:718-989-4877
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001213367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife