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General NPI Number Information
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NPI Number | 1568266971
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Entity Type | Individual
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Provider Name | SHAHABUDDIN HAQ
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Gender | Male
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 801 CO OP CITY BLVD
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City | BRONX
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State | NY
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Zip | 10475-1603
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Country | US
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Telephone | 718-239-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 14 IRVING AVE
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City | FLORAL PARK
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State | NY
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Zip | 11001-1624
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Country | US
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Telephone | 917-285-5751
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 356383
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License Number State | NY
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