1679645048 NPI number — MONOWARA BEGUM MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679645048 NPI number — MONOWARA BEGUM MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONOWARA BEGUM MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679645048
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
48 CONSTITUTION DR S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAPPAN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10983-1619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-359-7804
Provider Business Mailing Address Fax Number:
845-359-0457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
48 CONSTITUTION DR S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAPPAN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10983-1619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-359-7804
Provider Business Practice Location Address Fax Number:
845-359-0457
Provider Enumeration Date:
11/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BEGUM
Authorized Official First Name:
MONOWARA
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHIATRIST
Authorized Official Telephone Number:
845-359-7804

Provider Taxonomy Codes

  • Taxonomy code: 204D00000X , with the licence number:  153407 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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