Provider Demographics
NPI:1689828196
Name:TELI, IQBAL KARIM (MD)
Entity Type:Individual
Prefix:DR
First Name:IQBAL
Middle Name:KARIM
Last Name:TELI
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 1:5726 164TH ST
Mailing Address - Street 2:APT 1
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1450
Mailing Address - Country:US
Mailing Address - Phone:347-806-0804
Mailing Address - Fax:
Practice Address - Street 1:1600 HAZEL ST.
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-546-6569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2016-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119418207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00223905Medicaid
NY00223905Medicaid