Healthcare Provider Details

I. General information

NPI: 1588203681
Provider Name (Legal Business Name): SYEDIA HOQUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 11/27/2023
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 MAIN ST
WHITE PLAINS NY
10601-2418
US

IV. Provider business mailing address

4111 28TH AVE APT 15
ASTORIA NY
11103-2930
US

V. Phone/Fax

Practice location:
  • Phone: 646-966-8734
  • Fax:
Mailing address:
  • Phone: 646-966-8734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: