Healthcare Provider Details

I. General information

NPI: 1528697083
Provider Name (Legal Business Name): SADEQ KAWSAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MD SADEQ KAWSAR MD

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7718 101ST AVE
OZONE PARK NY
11416-1914
US

IV. Provider business mailing address

10743 79TH ST
OZONE PARK NY
11417-1106
US

V. Phone/Fax

Practice location:
  • Phone: 929-272-6204
  • Fax: 646-974-9206
Mailing address:
  • Phone: 929-272-6204
  • Fax: 646-974-9206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number326022-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: