Provider Demographics
NPI:1356493282
Name:HYDER, QUENTIN OLIVER (MD)
Entity Type:Individual
Prefix:DR
First Name:QUENTIN
Middle Name:OLIVER
Last Name:HYDER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:250 GRAND CONCOURSE
Mailing Address - Street 2:NARCO FREEDOM INCORPORATED
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5430
Mailing Address - Country:US
Mailing Address - Phone:718-292-2240
Mailing Address - Fax:718-292-3030
Practice Address - Street 1:401 E 147TH STREET
Practice Address - Street 2:NEW BEGINNINGS COMMUNITY COUNSELING CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455
Practice Address - Country:US
Practice Address - Phone:718-665-2456
Practice Address - Fax:718-402-5312
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2009-06-08
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Provider Licenses
StateLicense IDTaxonomies
NY09569312084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY919061Medicare PIN