Provider Demographics
NPI:1154416071
Name:QADIR, MUHAMMAD IRFAN (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:IRFAN
Last Name:QADIR
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 1:514 GRAMATAN AVE
Mailing Address - Street 2:SUITE P3
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3054
Mailing Address - Country:US
Mailing Address - Phone:845-627-6114
Mailing Address - Fax:845-627-8404
Practice Address - Street 1:514 GRAMATAN AVE
Practice Address - Street 2:SUITE P3
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-3054
Practice Address - Country:US
Practice Address - Phone:845-627-6114
Practice Address - Fax:845-627-8404
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2043421207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20Q281Medicare ID - Type Unspecified