A S M Tazul Islam, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

104094 Issued in NY

Practice address

9131 175TH St
Jamaica, NY 11432-5517

Phone

(718) 657-6363

NPI assigned

Jan 28, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1265063358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17810 WEXFORD TER APT 4R",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323014",
            "telephone_number": "347-820-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 175TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325517",
            "telephone_number": "718-657-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "A S M",
        "middle_name": "TAZUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "104094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark N. Ishmail, PHARMD
• Muhammad Atif Ishtiaq
• Michael Iskhakbayev, FNP
• Sarah Iskhakov, MS
• Sharona Iskhakov
• Fariba Islam
• Fatiha Islam, PHARMACIST
• MD Saiful Islam
• Mohammed Shahidul Islam
• Mymuna Islam

• Internal Medicine Physician in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.