Provider Demographics
NPI:1285230474
Name:HUQ, DANIEL MASUDUL (NP)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:MASUDUL
Last Name:HUQ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 ROUTE 66
Mailing Address - Street 2:FL 3
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2645
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:400 FRANK W BURR BLVD FL 2
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6839
Practice Address - Country:US
Practice Address - Phone:201-928-2300
Practice Address - Fax:201-692-3262
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01042900363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology