Healthcare Provider Details

I. General information

NPI: 1801824388
Provider Name (Legal Business Name): MOHAMMAD ASIF IQBAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MOHAMMAD ASIF IQBAL M.D.

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 LIBERTY AVE
BROOKLYN NY
11208-3411
US

IV. Provider business mailing address

17 CORTLAND CT
HUNTINGTON STATION NY
11746-4309
US

V. Phone/Fax

Practice location:
  • Phone: 646-287-9405
  • Fax: 866-637-2007
Mailing address:
  • Phone: 646-287-9405
  • Fax: 866-637-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number230025
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number230025
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number230025
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number230025
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number230025
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number230025
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: