Provider Demographics
NPI:1639234339
Name:QAISAR, HAMED H (MD)
Entity Type:Individual
Prefix:
First Name:HAMED
Middle Name:H
Last Name:QAISAR
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 1:116 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4204
Mailing Address - Country:US
Mailing Address - Phone:718-875-1573
Mailing Address - Fax:718-875-1652
Practice Address - Street 1:116 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4204
Practice Address - Country:US
Practice Address - Phone:718-875-1573
Practice Address - Fax:718-875-1652
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113712-1207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00207387Medicaid
NY00207387Medicaid
D34140Medicare UPIN