Provider Demographics
NPI:1629129382
Name:AKHTER, AAFAQUE (MD)
Entity Type:Individual
Prefix:
First Name:AAFAQUE
Middle Name:
Last Name:AKHTER
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:PO BOX 670700
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-0700
Mailing Address - Country:US
Mailing Address - Phone:508-285-8550
Mailing Address - Fax:
Practice Address - Street 1:821 W 21ST ST STE 206
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1500
Practice Address - Country:US
Practice Address - Phone:757-317-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2156372084P0800X
VA1012682502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry