MEDICARE: DR. NAUSHEEN MUNTIQA 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	207R00000X	Internal Medicine Physician	258610	NY

General Provider Information

NPI Number	:	1851553622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAUSHEEN MUNTIQA M.D

Provider Business Mailing Address
First Line	:	24 STURROCK WAY
Second Line	:
City	:	EAST SETAUKET
State	:	NY
Zip	:	11733-1048
Country	:	US
Telephone Number	:	973-997-8745
Fax Number	:

Provider Business Practice Location Address
First Line	:	79 MIDDLEVILLE RD
Second Line	:
City	:	NORTHPORT
State	:	NY
Zip	:	11768-2296
Country	:	US
Telephone Number	:	631-261-4400
Fax Number	:

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

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	06/14/2021

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