Basic Information
Provider Information
NPI: 1952808925
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAJID
FirstName: NOURMA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 374 STOCKHOLM ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112374006
CountryCode: US
TelephoneNumber: 5168170020
FaxNumber:  
Practice Location
Address1: 374 STOCKHOLM ST # AT
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112374006
CountryCode: US
TelephoneNumber: 7189637272
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2018
LastUpdateDate: 05/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X314699NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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