Healthcare Provider Details

I. General information

NPI: 1619650868
Provider Name (Legal Business Name): RESHMA HAQUE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 MADISON AVE RM 1501
NEW YORK NY
10016-0701
US

IV. Provider business mailing address

274 MADISON AVE RM 1501
NEW YORK NY
10016-0701
US

V. Phone/Fax

Practice location:
  • Phone: 212-203-1773
  • Fax: 646-665-4427
Mailing address:
  • Phone: 212-203-1773
  • Fax: 646-665-4427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120011-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: