Provider Demographics
NPI:1104845155
Name:SADIQUE, IFFAT APA (MD)
Entity Type:Individual
Prefix:MRS
First Name:IFFAT
Middle Name:APA
Last Name:SADIQUE
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 1:16806 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4341
Mailing Address - Country:US
Mailing Address - Phone:718-739-7400
Mailing Address - Fax:718-934-1449
Practice Address - Street 1:16806 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4341
Practice Address - Country:US
Practice Address - Phone:718-739-7400
Practice Address - Fax:718-934-1449
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230830-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02585142Medicaid
NY02585142Medicaid
1718P1Medicare ID - Type Unspecified