Healthcare Provider Details

I. General information

NPI: 1649666207
Provider Name (Legal Business Name): SYED MAQSOOD D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HEMPSTEAD TURNPIKE NASSAU HEALTH CARE CORP
EAST MEADOWS NY
11554
US

IV. Provider business mailing address

1345 RXR PLZ FL 13
UNIONDALE NY
11556-1301
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-6637
  • Fax:
Mailing address:
  • Phone: 516-453-0435
  • Fax: 646-846-3283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number293001
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: