1003469222 NPI number — SYEDQAMBAR R NAQVI PHYSICIAN P.C.

Table of content: (NPI 1003469222)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003469222 NPI number — SYEDQAMBAR R NAQVI PHYSICIAN P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SYEDQAMBAR R NAQVI PHYSICIAN P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003469222
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
107 WEST MAIN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST ISLIP
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-688-1015
Provider Business Mailing Address Fax Number:
631-688-1700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
107 WEST MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST ISLIP
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-688-1015
Provider Business Practice Location Address Fax Number:
631-688-1700
Provider Enumeration Date:
07/17/2019

Additional Information

Authorized Official

Authorized Official Last Name:
NAQVI
Authorized Official First Name:
SYEDQAMBAR
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CREDENTIALIGN SPECIALIST
Authorized Official Telephone Number:
631-666-1615

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com