Provider Demographics
NPI:1396781415
Name:HASHMAT, AIZID IQTEDAR (MD)
Entity type:Individual
Prefix:DR
First Name:AIZID
Middle Name:IQTEDAR
Last Name:HASHMAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HANSON PL
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11243-2900
Mailing Address - Country:US
Mailing Address - Phone:718-622-0078
Mailing Address - Fax:718-622-0077
Practice Address - Street 1:1 HANSON PL
Practice Address - Street 2:SUITE 401
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11243-2900
Practice Address - Country:US
Practice Address - Phone:718-622-0078
Practice Address - Fax:718-622-0077
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137915174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00498682Medicaid
NYAH1867970OtherDEA
NY32A031Medicare ID - Type Unspecified
NY00498682Medicaid