Healthcare Provider Details

I. General information

NPI: 1003573494
Provider Name (Legal Business Name): DR. JAVAID IFTIKHAR, DNP, NP IN PSYCHIATRY AND FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2021
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2216 KIMBALL ST # AT6M
BROOKLYN NY
11234-5111
US

IV. Provider business mailing address

2216 KIMBALL ST # AT6M
BROOKLYN NY
11234-5111
US

V. Phone/Fax

Practice location:
  • Phone: 718-743-0610
  • Fax:
Mailing address:
  • Phone: 718-743-0610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JAVAID HASSAN IFTIKHAR
Title or Position: OWNER
Credential: DNP
Phone: 718-743-0610