Healthcare Provider Details

I. General information

NPI: 1629876511
Provider Name (Legal Business Name): FIZA IQBAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 WOODBINE ST
BROOKLYN NY
11221-4944
US

IV. Provider business mailing address

83 WOODBINE ST
BROOKLYN NY
11221-4944
US

V. Phone/Fax

Practice location:
  • Phone: 646-780-9050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: