M.Q. Islam Physician PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

36373 Issued in NY

Legal business name

M.Q. ISLAM PHYSICIAN PLLC

Practice address

20 Old Courthouse Rd
Manhasset Hills, NY 11040-1229

Phone

(718) 657-8525

NPI assigned

Apr 11, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohammed Q IslamNPI 1245205012

Title

Medical Director

Phone

(718) 657-8525

Specialties & licenses 1

Addresses

Tax ID family

M Q Islam Physician PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• M Q Islam Physician, PLLC

  • Neurology Physician
  • Elmhurst, NY
  • NPI 1033543707
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammed Qamrul Islam, MD

  • Neuromusculoskeletal Medicine & OMM Physician
  • Elmhurst, NY
  • NPI 1245205012
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1053601005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16832 HIGHLAND AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322640",
            "telephone_number": "718-657-8525",
            "fax_number": "718-657-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 OLD COURTHOUSE RD",
            "city": "MANHASSET HILLS",
            "state": "NY",
            "postal_code": "110401229",
            "telephone_number": "718-657-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.Q. ISLAM PHYSICIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "ISLAM",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-657-8525",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "36373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sajid Latif Khan, M.D.
• Afshan Khwaja, MLSW
• Irine J Kim, MD
• Jennifer Kordvani, MS
• Sunita Kumar, R.PH
• Jerrill Mathew, DPT
• Ilyse Metzger
• Paul Milone, DPM
• Amara Mirza, RPH
• Patricia Moss, PH.D.

• Specialist in Manhasset Hills, NY
• Providers in Manhasset Hills, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.