MEDICARE: DR. TARIQ WASEEM M.D.

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	208D00000X	General Practice Physician	126149	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	126149	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1366517930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARIQ WASEEM M.D.

Provider Business Mailing Address
First Line	:	3636 33RD ST STE 306
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-2329
Country	:	US
Telephone Number	:	844-403-4325
Fax Number	:	424-625-0010

Provider Business Practice Location Address
First Line	:	3636 33RD ST STE 306
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-2329
Country	:	US
Telephone Number	:	844-403-4325
Fax Number	:	424-625-0010

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	05/23/2022

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