Provider Demographics
NPI:1851553622
Name:MUNTIQA, NAUSHEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NAUSHEEN
Middle Name:
Last Name:MUNTIQA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:NAUSHEEN
Other - Middle Name:
Other - Last Name:MUJTABA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24 STURROCK WAY
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1048
Mailing Address - Country:US
Mailing Address - Phone:973-997-8745
Mailing Address - Fax:
Practice Address - Street 1:79 MIDDLEVILLE RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2296
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258610207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine