Provider Demographics
NPI:1003079286
Name:HANIF, SYRA (MD)
Entity Type:Individual
Prefix:
First Name:SYRA
Middle Name:
Last Name:HANIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:492 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8404
Mailing Address - Country:US
Mailing Address - Phone:646-454-9000
Mailing Address - Fax:646-454-9047
Practice Address - Street 1:492 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8404
Practice Address - Country:US
Practice Address - Phone:646-454-9000
Practice Address - Fax:646-454-9047
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282778207Q00000X
TXP0403207Q00000X
NJ25MA09131200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05569264Medicaid
TX8CZ067OtherBLUE CORSS