Provider Demographics
NPI:1265708952
Name:IFTIKHAR A. SYED, M.D., F.A.C.S., P.C.
Entity type:Organization
Organization Name:IFTIKHAR A. SYED, M.D., F.A.C.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IFTIKHAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-370-1814
Mailing Address - Street 1:1201 NOTT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2589
Mailing Address - Country:US
Mailing Address - Phone:518-370-1814
Mailing Address - Fax:518-370-1830
Practice Address - Street 1:1201 NOTT ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-370-1814
Practice Address - Fax:518-370-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1428081174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1457457855Medicaid
NY10002013OtherCDPHP
NY1457457855Medicaid