Provider Demographics
NPI:1417900721
Name:NAQVI, SYED HASAN MAHBOOB (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:HASAN MAHBOOB
Last Name:NAQVI
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 1:74 W CEDAR ST
Mailing Address - Street 2:2A
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1310
Mailing Address - Country:US
Mailing Address - Phone:845-452-7319
Mailing Address - Fax:
Practice Address - Street 1:74 W CEDAR ST
Practice Address - Street 2:2A
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1310
Practice Address - Country:US
Practice Address - Phone:845-452-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229446207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02709268Medicaid
NY670P71Medicare ID - Type Unspecified
NYG51339Medicare UPIN