MEDICARE: EMERALD MEDICAL NY PC

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

General Provider Information

NPI Number	:	1508605973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERALD MEDICAL NY PC

Provider Business Mailing Address
First Line	:	5209 BURNET RD UNIT 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-2443
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5209 BURNET RD UNIT 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-2443
Country	:	US
Telephone Number	:	855-422-3855
Fax Number	:

Authorized Official
Title or Position	:	AO
Name	:	SABA HAQ
Credential	:	MD
Telephone Number	:	949-463-0650

Provider Enumeration Date	:	05/23/2024
Last Update Date	:	06/03/2026

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Directions to “EMERALD MEDICAL NY PC ” Practice Location

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