MOHAMMED NAZRUL ISLAM (NPI# 1558472977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558472977 |
| Entity Type | Individual |
| Full Name | MOHAMMED NAZRUL ISLAM |
| Credential | M.D. |
| Practice Address |
243 Pine St Mount Holly NJ 08060-2201 |
| Mailing Address |
23 Annapolis Dr Marlton NJ 08053-3833 |
| Practice Telephone | 6092671550 |
| Mailing Telephone | 2677795239 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
25MA07918000 | NJ | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
25MA07918000 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0083577 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 905 Herrontown Rd, Princeton, NJ 085401901 | 6094973300 | 6094973370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174094734 | Mohammed Shafayetul Islam | Dentist | 2610 E Nees Ave Apt 133, Fresno, CA 93720-6016 | 2018-12-07 |
| 1407179831 | Mohammed Aminul Islam | Pharmacist | 7 Shetland Cir, Highland Mills, NY 10930-8303 | 2010-03-12 |
| 1346479953 | Mohammed F Islam | Registered Nurse | 4308 40th St, 6d, Sunnyside, NY 11104-3830 | 2009-07-06 |
| 1942460670 | Mohammed Mominul Islam | Internal Medicine | 526 Pacific Ave, Apartment Number 407, Atlantic City, NJ 08401-7662 | 2008-06-16 |
| 1891896551 | Mohammed S Islam | Pharmacist | 72 Storey Ln, Yonkers, NY 10710-4412 | 2006-09-26 |
| 1114938461 | Mohammed Islam | Internal Medicine | Rbmc 530 New Brunswick Ave, Dept of Internal Medicine, Perth Amboy, NJ 08861 | 2006-08-11 |
| 1669415386 | Mohammed Shahidul Islam | Psychiatry & Neurology | 2014 Charlotte Avenue, Nashville, TN 37203 | 2006-06-13 |
| 1245205012 | Mohammed Qamrul Islam | Neuromusculoskeletal Medicine & OMM | 40-27, 74th Street, Elmhurst, NY 11040-2505 | 2006-02-23 |
| 1992322101 | Mohammed Shahidul Islam | Internal Medicine | 9131 175th St, Jamaica, NY 11432-5517 | 2020-07-03 |
| 1548729346 | Mohammed Mofedul Islam | Student in an Organized Health Care Education/Training Program | 300 Community Dr, Manhasset, NY 11030-3816 | 2019-03-19 |
| Street Address |
243 PINE ST |
| City | MOUNT HOLLY |
| State | NJ |
| Zip Code | 08060-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366949489 | Legacy Treatment Serivces, Inc. | Psychiatric Residential Treatment Facility | 243 Pine St, Mount Holly, NJ 08060-2201 | 2018-04-06 |
| 1801394986 | Legacy Treatment Serivces, Inc. | Psychiatric Residential Treatment Facility | 243 Pine St, Mount Holly, NJ 08060-2201 | 2018-01-24 |
| 1639677644 | Legacy Treatment Serivces, Inc. | Psychiatric Residential Treatment Facility | 243 Pine St, Mount Holly, NJ 08060-2201 | 2018-01-24 |
| 1417329442 | Legacy Treatment Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 243 Pine St, Mount Holly, NJ 08060-2201 | 2015-10-29 |
| 1710397799 | Union Association of The Children's Home of Burlington County | Residential Treatment Facility, Emotionally Disturbed Children | 243 Pine St, Mount Holly, NJ 08060-2201 | 2014-04-30 |
| 1891047072 | Union Association of The Children's Home of Burlington County | Residential Treatment Facility, Emotionally Disturbed Children | 243 Pine St, Mount Holly, NJ 08060-2201 | 2012-10-11 |
| 1265691893 | Union Association of The Children's Home of Burlington County | Residential Treatment Facility, Emotionally Disturbed Children | 243 Pine St, Mount Holly, NJ 08060-2201 | 2008-06-09 |
| 1992964027 | Union Association of The Childrens Home of Burlington County | Residential Treatment Facility, Emotionally Disturbed Children | 243 Pine St, Mount Holly, NJ 08060-2201 | 2008-06-04 |
| 1619136744 | Union Association of The Childrens Home of Burlington County | Residential Treatment Facility, Emotionally Disturbed Children | 243 Pine St, Mount Holly, NJ 08060-2201 | 2008-06-04 |
| 1336308477 | Union Association of The Childrens Home of Burlington County | Residential Treatment Facility, Emotionally Disturbed Children | 243 Pine St, Mount Holly, NJ 08060-2201 | 2008-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821613092 | Priscilla Gonzales | Counselor | 795 Woodlane Road, Suite 301, Mount Holly, NJ 08060 | 2020-06-12 |
| 1255838157 | Frederick Hart IIi | Occupational Therapist | 1934 Burlington-mt. Holly Road Suite A, Westampton, NJ 08060 | 2018-04-09 |
| 1457860116 | Lea Gartenmayer | Speech-Language Pathologist | 1934 Burlington-mount Holly Rd, Westampton, NJ 08060 | 2017-09-26 |
| 1295261618 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 202 Burrs Rd, Westampton, NJ 08060 | 2017-05-04 |
| 1871038620 | Michael Green. | Counselor | 770 Wooland Road, Westampton, NJ 08060 | 2017-01-04 |
| 1851841696 | Virtua Medical Group, Pa | Clinic/Center | 555 High St, Suite 16a, Mount Holly, NJ 08060 | 2016-10-05 |
| 1821441213 | Joseph Cooper Sr. | Counselor | 770 Woodlene Road, Westampton, NJ 08060 | 2016-07-20 |
| 1790148724 | Leah Holden | Pharmacist | 531 High St, Mt Holly, NJ 08060 | 2016-03-29 |
| 1083088892 | Joanne Hawkins | Counselor | 770 Woodlane Rd. Suite 35, Mt. Holly, NJ 08060 | 2015-11-17 |
| 1730557448 | Legacy Treatment Services | In Home Supportive Care | 243 Pine Street, Mount Holly, NJ 08060 | 2015-09-11 |
| Find all providers in zip 08060 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063059079 | Rr & C Associates | Psychiatry & Neurology | 705 Birchfield Dr, Mount Laurel, NJ 08054-4013 | 2019-12-09 |
| 1154888162 | St. Luke's Counseling Medical Center L.L.C. | Psychiatry & Neurology | 59 Seeley Ave, Kearny, NJ 07032-3120 | 2019-02-26 |
| 1194297614 | Childpsych Services, LLC | Psychiatry & Neurology | 940 Cedar Bridge Ave Fl 2, Brick, NJ 08723-4170 | 2018-12-21 |
| 1003279308 | Medisol, LLC | Psychiatry & Neurology | 226 Fisher Ave, Piscataway, NJ 08854-4833 | 2016-04-04 |
| 1043637465 | Jason Dean | Psychiatry & Neurology | 400 Frank W Burr Blvd # 6, Teaneck, NJ 07666-6839 | 2014-03-24 |
| 1184963837 | Prospect Psychiatric Services Limited Liability Company | Psychiatry & Neurology | 344 Prospect Ave Apt 1a, Hackensack, NJ 07601-2602 | 2013-01-31 |
| 1174870034 | Naomi Ambalu | Psychiatry & Neurology | 266 King George Rd Ste G, Warren, NJ 07059-5187 | 2012-08-10 |
| 1699022558 | Nanda Muthusawmy | Psychiatry & Neurology | 210 Malapardis Rd Ste 205, Cedar Knolls, NJ 07927 | 2012-08-10 |
| 1144512674 | Magalie Saint-lot Jacques | Psychiatry & Neurology | 31 Bridgewater Ct, Jackson, NJ 08527-4030 | 2011-05-03 |
| 1043501265 | Kathreen Tharwat Tadrous | Psychiatry & Neurology | 655 E. Jersey Sreet, Trinitas Regional Medical Center, Elizabeth, NJ 07206 | 2011-04-21 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT HOLLY |
| Zip Code | 08060 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.