Provider Demographics
NPI:1770832503
Name:AFSHAN HAQUE, DDS, P.C
Entity Type:Organization
Organization Name:AFSHAN HAQUE, DDS, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:AFSHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-470-1000
Mailing Address - Street 1:565 W 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3424
Mailing Address - Country:US
Mailing Address - Phone:212-470-1000
Mailing Address - Fax:800-604-6146
Practice Address - Street 1:565 W 125TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-3424
Practice Address - Country:US
Practice Address - Phone:212-470-1000
Practice Address - Fax:800-604-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0510761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty