Basic Information
| Provider Information | |||||||||
| NPI: | 1013199405 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JUNAID HASHIM MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1275 DELAWARE AVE | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142092412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168865493 | ||||||||
| FaxNumber: | 7168865835 | ||||||||
| Practice Location | |||||||||
| Address1: | 5904 SHERIDAN DR, STE 1 | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168319435 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2007 | ||||||||
| LastUpdateDate: | 04/20/2020 | ||||||||
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| AuthorizedOfficialLastName: | HASHIM | ||||||||
| AuthorizedOfficialFirstName: | JUNAID | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7168865493 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 04/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 1698601 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 01521333 | 05 | NY | MEDICAID |