Provider Demographics
NPI:1285875138
Name:HAMED H. QAISAR P.C.
Entity type:Organization
Organization Name:HAMED H. QAISAR P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:QAISAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-875-1573
Mailing Address - Street 1:116 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4204
Mailing Address - Country:US
Mailing Address - Phone:718-875-1573
Mailing Address - Fax:718-875-1652
Practice Address - Street 1:116 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4204
Practice Address - Country:US
Practice Address - Phone:718-875-1573
Practice Address - Fax:718-875-1652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113712207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00207387Medicaid
NYD34140Medicare UPIN