Healthcare Provider Details

I. General information

NPI: 1992616759
Provider Name (Legal Business Name): SHAFIQUE MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26701 HILLSIDE AVE
FLORAL PARK NY
11004-1743
US

IV. Provider business mailing address

8454 257TH ST
FLORAL PARK NY
11001-1004
US

V. Phone/Fax

Practice location:
  • Phone: 718-343-7790
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WAQAS SHAFIQUE
Title or Position: PHYSICIAN
Credential: MD
Phone: 347-824-1682