Provider Demographics
NPI:1104244524
Name:KHALID, MUHAMMAD TANWEER (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:TANWEER
Last Name:KHALID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MUHAMMAD
Other - Middle Name:T
Other - Last Name:KHALID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD ( PSYCHIATRY)
Mailing Address - Street 1:2 FUSCHETTO CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4262
Mailing Address - Country:US
Mailing Address - Phone:718-300-9739
Mailing Address - Fax:
Practice Address - Street 1:2201 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1859
Practice Address - Country:US
Practice Address - Phone:718-300-9739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292304-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry