| Doctor Name: | DR. ABU M.R ISLAM |
| NPI Number: | 1295988814 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 121552 |
| Business Practice Address: | 3108 76th St First Fl East Elmhurst, NY - 113701823 |
| Business Phone Number: | 7184244211 |
| Business Fax Number: | |
| Mailing Address: | 3108 76th St, First Fl EAST ELMHURST |
| State: | NY |
| Postal Code: | 113701823 |
| Phone Number: | 7184244211 |
| Fax Number: | |
| NPI Enumeration Date: | 10/28/2008 |
| NPI Last Update Date: | 10/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 121552 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |