Provider Demographics
NPI:1386632057
Name:SAIF, WASIF M (MD)
Entity Type:Individual
Prefix:
First Name:WASIF
Middle Name:M
Last Name:SAIF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MARCUS AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LAKE SUCCESS
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:516-321-2238
Mailing Address - Fax:516-321-2272
Practice Address - Street 1:450 LAKEVILLE ROAD
Practice Address - Street 2:
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-734-8990
Practice Address - Fax:516-734-7684
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257954207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001431460Medicaid
CT900000035Medicare ID - Type Unspecified
H33960Medicare UPIN