Provider Demographics
NPI:1245127281
Name:TAMIM, NADIRA TAMANNA
Entity type:Individual
Prefix:
First Name:NADIRA
Middle Name:TAMANNA
Last Name:TAMIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 VIRGINIA AVE APT 7H
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7329
Mailing Address - Country:US
Mailing Address - Phone:929-687-8491
Mailing Address - Fax:
Practice Address - Street 1:15715 19TH AVE
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3820
Practice Address - Country:US
Practice Address - Phone:718-746-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP135952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine