Provider Demographics
NPI:1316988165
Name:MAJUMDER, MUJIBUR R (MD)
Entity type:Individual
Prefix:
First Name:MUJIBUR
Middle Name:R
Last Name:MAJUMDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:9 PLANE TREE LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5109
Mailing Address - Country:US
Mailing Address - Phone:718-240-5236
Mailing Address - Fax:718-240-6592
Practice Address - Street 1:1 BROOKDALE PLZ
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3139
Practice Address - Country:US
Practice Address - Phone:718-240-5236
Practice Address - Fax:718-240-6592
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013043834207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
NY227995207RC0200X, 207RG0300X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02599402Medicaid
NY02599402Medicaid
I22438Medicare UPIN