Provider Demographics
NPI:1821183948
Name:MERCHANT, IQBAL (MD)
Entity Type:Individual
Prefix:
First Name:IQBAL
Middle Name:
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:IQBAL
Other - Middle Name:
Other - Last Name:MERCHANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:170 WEST 233RD STREET
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463
Mailing Address - Country:US
Mailing Address - Phone:718-543-0700
Mailing Address - Fax:718-543-0788
Practice Address - Street 1:170 WEST 233RD STREET
Practice Address - Street 2:SUITE 1A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463
Practice Address - Country:US
Practice Address - Phone:718-543-0700
Practice Address - Fax:718-543-0788
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153243204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1657510Medicaid
B13810Medicare UPIN
NY1657510Medicaid