Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 288420 | NY |
Y | 207RP1001X | Pulmonary Disease | 288420 | NY |
NPI | 1013334309 |
---|---|
Provider Name | Marjan Islam |
First Address | New York, NY 10128-4019 |
Second Address | Bronx, NY 10467-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2014 |
Last Update Date | 08/05/2020 |