Healthcare Provider Details

I. General information

NPI: 1821183948
Provider Name (Legal Business Name): IQBAL MERCHANT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: IQBAL MERCHANT MD

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 WEST 233RD STREET SUITE 1A
BRONX NY
10463
US

IV. Provider business mailing address

170 WEST 233RD STREET SUITE 1A
BRONX NY
10463
US

V. Phone/Fax

Practice location:
  • Phone: 718-543-0700
  • Fax: 718-543-0788
Mailing address:
  • Phone: 718-543-0700
  • Fax: 718-543-0788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number153243
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: