Provider Demographics
NPI:1003469222
Name:SYEDQAMBAR R NAQVI PHYSICIAN P.C.
Entity Type:Organization
Organization Name:SYEDQAMBAR R NAQVI PHYSICIAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALIGN SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SYEDQAMBAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:NAQVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-666-1615
Mailing Address - Street 1:107 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730
Mailing Address - Country:US
Mailing Address - Phone:631-688-1015
Mailing Address - Fax:631-688-1700
Practice Address - Street 1:107 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730
Practice Address - Country:US
Practice Address - Phone:631-688-1015
Practice Address - Fax:631-688-1700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYEDQAMBAR R NAQVI PHYSICIAN P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty