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Mosammat Ireen Alam

Physician Assistant in Jamaica, NY. Individual provider (NPI-1).

NPI number1316645765
StatusActive
Last updated in NPPESSep 22, 2023

Details

NPI
1316645765
Entity type
Individual (NPI-1)
Name
Mosammat Ireen Alam
Sex
Female
Sole proprietor
No
Enumeration date
Feb 15, 2023
Certification date
Sep 22, 2023
Last updated
Sep 22, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant029702-01NYYes

Practice location

9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001

Phone 718-262-2000

Mailing address

9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001

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