Mohammed Shafiul Alam, MBBS, MD
Individual provider Active NPI Internal Medicine Physician · Fresh Meadows, NY
NPI 1902500390 · NPPES record last updated Mar 29, 2023
Key facts
- NPI
- 1902500390
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- P120824 (NY)
- Practice address
- 7810 164TH St
Fresh Meadows, NY 11366-1229 - Phone
- (718) 709-0940
- NPI assigned
- Mar 29, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230824003832 | NY | Practitioner - Internal Medicine | 3476916388 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | P120824 | NY | Yes |
Addresses
Primary practice location
7810 164TH St
Fresh Meadows, NY 11366-1229
Mailing address
6136 170TH St Apt M4
Fresh Meadows, NY 11365-1957
Phone (917) 582-7278
Other practice location 1
1410 Seagirt Blvd
Far Rockaway, NY 11691-9879
Phone (347) 709-3133
Other practice location 2
14040 Sanford Ave
Flushing, NY 11355-2556
Phone (347) 709-3133
Other practice location 3
11126 Corona Ave
Flushing, NY 11368-4096
Phone (347) 709-3133
Other practice location 4
8008 45th Ave
Elmhurst, NY 11373-3545
Phone (347) 709-3133
Other practice location 5
123 Linden Blvd
Brooklyn, NY 11226-9702
Phone (718) 709-0940
Other practice location 6
6995 Queens Midtown Expy
Maspeth, NY 11378-1999
Phone (718) 709-0940
Other practice location 7
9131 175th St
Jamaica, NY 11432-5517
Phone (718) 709-0940
Other practice location 8
10825 Horace Harding Expy
Corona, NY 11368-4532
Phone (947) 709-3133
Other practice location 9
2830 Pitkin Ave
Brooklyn, NY 11208-3220
Phone (215) 459-3787
Other practice location 10
2749 Linden Blvd
Brooklyn, NY 11208-5110
Phone (516) 364-3241
Other practice location 11
1311 Virginia St
Far Rockaway, NY 11691-4630
Phone (347) 709-3133
Other practice location 12
31 Lockwood Ave
New Rochelle, NY 10801-5023
Phone (215) 459-3787
Other providers in Fresh Meadows, NY
- Aeilee Ahn
- Vyungjean Ahn
- Christine Ajodha
- Ake Services, Inc
- Jesmin Akhter
- Eman Alamin
- Alan Antonelli M.D. PC
- Yelena Alayeva
- Nelson Alcaraz
- Evelyn Aldapa
All providers in Fresh Meadows, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.