Syeda Fatema Mamun, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200016 Issued in NY

Practice address

2094 Pitkin Ave
Pediatrics Department -Eny Diagnostic & Treatment Ctr
Brooklyn, NY 11207

Phone

(718) 240-0516

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: smamun1054236@nychhc.direct-ci.com

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1669425500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 PITKIN AVENUE",
            "address_2": "EAST NEW YORK DIAGNOSTIC & TREATMENT CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11207",
            "telephone_number": "718-240-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2094 PITKIN AVE",
            "address_2": "PEDIATRICS DEPARTMENT -ENY DIAGNOSTIC & TREATMENT CTR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11207",
            "telephone_number": "718-240-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMUN",
        "first_name": "SYEDA",
        "middle_name": "FATEMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "200016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01717495",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicki Anne Mammano, PSY.D
• Narhanym Mammedova, MSED
• Cristina Mammoliti
• Mamre Seventh-Day Adventist Church
• Samila Mamtsis
• Kathy Kwok Fun Man-Wong, M.D.
• Ammy Man
• Winson Man
• Loreta Mana
• Ron Ron-El Mana, M.D.

• Pediatrics Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.