Provider Demographics
NPI:1902461270
Name:M L NAHAR MEDICAL OFFICE PLLC
Entity Type:Organization
Organization Name:M L NAHAR MEDICAL OFFICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:MOST
Authorized Official - Middle Name:
Authorized Official - Last Name:NAHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-284-5361
Mailing Address - Street 1:92 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1008
Mailing Address - Country:US
Mailing Address - Phone:718-360-0907
Mailing Address - Fax:718-395-1737
Practice Address - Street 1:8712 175TH ST UNIT 2A
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5776
Practice Address - Country:US
Practice Address - Phone:718-360-0907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03343102Medicaid