Healthcare Provider Details

I. General information

NPI: 1841391737
Provider Name (Legal Business Name): JAVED IQBAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 EAST 210TH STREET MONTEFIORE MEDICAL CENTER
BRONX NY
10467
US

IV. Provider business mailing address

2201 HEMPSTEAD TPKE BUILDING B ROOM 346
EAST MEADOW NY
11554-1859
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-8442
  • Fax: 516-465-1830
Mailing address:
  • Phone: 516-572-8714
  • Fax: 516-465-1830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number258483
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number258483
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: