Provider Demographics
NPI:1932247046
Name:MAHABIR, PARMESHWAR JAGDEO (MD)
Entity Type:Individual
Prefix:DR
First Name:PARMESHWAR
Middle Name:JAGDEO
Last Name:MAHABIR
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 1:18712 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3216
Mailing Address - Country:US
Mailing Address - Phone:718-264-2925
Mailing Address - Fax:718-264-2949
Practice Address - Street 1:18712 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3216
Practice Address - Country:US
Practice Address - Phone:718-264-2925
Practice Address - Fax:718-264-2949
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201728207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01843654Medicaid
NY01496Medicare ID - Type Unspecified
NY01843654Medicaid