Provider Demographics
NPI:1396060802
Name:MEMON, JAMSHEED RASHEED
Entity type:Individual
Prefix:
First Name:JAMSHEED
Middle Name:RASHEED
Last Name:MEMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13838 THE LAKES BLVD APT NO7204
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5634
Mailing Address - Country:US
Mailing Address - Phone:512-252-3373
Mailing Address - Fax:
Practice Address - Street 1:79 MIDDLEVILLE ROAD
Practice Address - Street 2:DEPT OF VETERANS AFFAIRS
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:631-266-6091
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program