Healthcare Provider Details

I. General information

NPI: 1447160106
Provider Name (Legal Business Name): M HAQUE MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11-19 RIVER RD
FAIR LAWN NJ
07410-1463
US

IV. Provider business mailing address

565 W 125TH ST
NEW YORK NY
10027-3424
US

V. Phone/Fax

Practice location:
  • Phone: 212-470-1000
  • Fax:
Mailing address:
  • Phone: 212-470-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD M HAQUE
Title or Position: OWNER
Credential: MD
Phone: 212-470-1000