Provider Demographics
NPI:1750321030
Name:SAQIB, JAVED I (MD)
Entity type:Individual
Prefix:DR
First Name:JAVED
Middle Name:I
Last Name:SAQIB
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 1:11 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3810
Mailing Address - Country:US
Mailing Address - Phone:718-462-7315
Mailing Address - Fax:718-462-7379
Practice Address - Street 1:693 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4306
Practice Address - Country:US
Practice Address - Phone:718-462-7315
Practice Address - Fax:718-462-7379
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192826207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01553319Medicaid
NYF95905Medicare UPIN
NY01553319Medicaid