Provider Demographics
NPI:1265113930
Name:IQBAL, MOMIN
Entity type:Individual
Prefix:
First Name:MOMIN
Middle Name:
Last Name:IQBAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HARRISON AVE APT 2H
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3964
Mailing Address - Country:US
Mailing Address - Phone:480-529-8144
Mailing Address - Fax:
Practice Address - Street 1:NYU LANGONE HOSPITAL LONG ISLAND
Practice Address - Street 2:DEPT OF PATHOLOGY, 222 STATION PLAZA NORTH, SUITE 618
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-663-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program