Provider Demographics
NPI:1609835172
Name:TEJANI, FURQAN HUSSAIN (MD)
Entity type:Individual
Prefix:
First Name:FURQAN
Middle Name:HUSSAIN
Last Name:TEJANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5940
Mailing Address - Country:US
Mailing Address - Phone:718-522-3399
Mailing Address - Fax:
Practice Address - Street 1:260 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5940
Practice Address - Country:US
Practice Address - Phone:718-522-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241407207RC0000X
FLME159089207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116323300Medicaid
NY02555466Medicaid
570Q01Medicare ID - Type Unspecified