Provider Demographics
NPI:1407957863
Name:HAQ, INAM UL (MD)
Entity Type:Individual
Prefix:DR
First Name:INAM
Middle Name:UL
Last Name:HAQ
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 1:966 50TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3309
Mailing Address - Country:US
Mailing Address - Phone:718-435-1831
Mailing Address - Fax:718-435-2748
Practice Address - Street 1:966 50TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3309
Practice Address - Country:US
Practice Address - Phone:718-435-1831
Practice Address - Fax:718-435-2748
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1197222086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00251529Medicaid
A66209Medicare UPIN
NY00251529Medicaid