Healthcare Provider Details

I. General information

NPI: 1265396121
Provider Name (Legal Business Name): MUQADDES WAQAR MS, RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 VAN WYCK EXPY
RICHMOND HILL NY
11418-2897
US

IV. Provider business mailing address

10908 110TH ST
SOUTH OZONE PARK NY
11420-1013
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-6000
  • Fax:
Mailing address:
  • Phone: 374-741-2574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86300223
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: