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General NPI Number Information
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NPI Number | 1144265760
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Entity Type | Individual
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Provider Name | MASOOM QADEER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 1755 DEER PARK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-5207
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Country | US
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Telephone | 631-281-7246
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Fax | 631-629-4477
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Provider Business Mailing Address
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Address Line | PO BOX 2661
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-0515
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Country | US
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Telephone | 631-281-7246
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Fax | 631-629-4477
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 197780
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 197780
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License Number State | NY
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