Provider Demographics
NPI:1992300016
Name:MURSHED, TAMRINA (PA-C)
Entity type:Individual
Prefix:
First Name:TAMRINA
Middle Name:
Last Name:MURSHED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 FLOWER LN
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1906
Mailing Address - Country:US
Mailing Address - Phone:516-587-9611
Mailing Address - Fax:
Practice Address - Street 1:761 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6608
Practice Address - Country:US
Practice Address - Phone:888-444-6974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025893363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant