Healthcare Provider Details

I. General information

NPI: 1508972332
Provider Name (Legal Business Name): DR. RIFFAT PREVEEN IQBAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RIFFAT PREVEEN IQBAL MD

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 BELMONT AVE
YOUNGSTOWN OH
44505-1052
US

IV. Provider business mailing address

2725 ARABIAN DR
HUBBARD OH
44425-2745
US

V. Phone/Fax

Practice location:
  • Phone: 330-759-9670
  • Fax: 330-759-9705
Mailing address:
  • Phone: 330-759-9670
  • Fax: 330-759-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35051567
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: