Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 206210 | NY |
NPI | 1396747135 |
---|---|
Provider Name | Dr. Nooruddin Rahmatullah Tejani |
First Address | Syosset, NY 11791-6130 |
Second Address | Brooklyn, NY 11203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 08/07/2007 |