MEDICARE: ANEEQA BABAR DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	316983	NY
2	208000000X	Pediatrics Physician	25MB11498400	NJ

General Provider Information

NPI Number	:	1003470782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANEEQA BABAR DO

Provider Business Mailing Address
First Line	:	475 SEAVIEW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-3436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 MCWILLIAMS PL
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-1609
Country	:	US
Telephone Number	:	718-226-7666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2019
Last Update Date	:	09/10/2022

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