Provider Demographics
NPI:1639165715
Name:SALUJA, IQBAL K (MD)
Entity Type:Individual
Prefix:
First Name:IQBAL
Middle Name:K
Last Name:SALUJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-4102
Mailing Address - Country:US
Mailing Address - Phone:718-827-4321
Mailing Address - Fax:718-827-0415
Practice Address - Street 1:756 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-4102
Practice Address - Country:US
Practice Address - Phone:718-827-4321
Practice Address - Fax:718-827-0415
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117843207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01811930Medicaid
NY01811930Medicaid
E87259Medicare UPIN