Basic Information
Provider Information
NPI: 1598885741
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIKDER
FirstName: MANZURUL
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1729 BURRSTONE ROAD
Address2: SLOCUM DICKSON MEDICAL GROUP PLLC
City: NEW HARTFORD
State: NY
PostalCode: 13413
CountryCode: US
TelephoneNumber: 3157981500
FaxNumber: 3157981707
Practice Location
Address1: 1729 BURRSTONE ROAD
Address2: SLOCUM DICKSON MEDICAL GROUP PLLC
City: NEW HARTFORD
State: NY
PostalCode: 13413
CountryCode: US
TelephoneNumber: 3157981500
FaxNumber: 3157981707
Other Information
ProviderEnumerationDate: 03/30/2007
LastUpdateDate: 03/12/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X245286NYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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