Provider Demographics
NPI:1104149806
Name:IQBAL, SYED (PHARMD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:IQBAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 48TH ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1312
Mailing Address - Country:US
Mailing Address - Phone:917-754-4150
Mailing Address - Fax:
Practice Address - Street 1:26 WICKS RD
Practice Address - Street 2:WALGREENS
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-3509
Practice Address - Country:US
Practice Address - Phone:631-637-3317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist