Provider Demographics
NPI:1003173527
Name:IQBAL, SYED HASAN (DO)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:HASAN
Last Name:IQBAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:891 NORTHERN BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5305
Mailing Address - Country:US
Mailing Address - Phone:516-773-6300
Mailing Address - Fax:516-706-4700
Practice Address - Street 1:891 NORTHERN BLVD STE 203
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021
Practice Address - Country:US
Practice Address - Phone:516-773-6300
Practice Address - Fax:516-706-4700
Is Sole Proprietor?:No
Enumeration Date:2012-04-22
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279603207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease