Provider Demographics
NPI:1427609825
Name:TARIQ, BILAL
Entity type:Individual
Prefix:MR
First Name:BILAL
Middle Name:
Last Name:TARIQ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14800 4TH ST APT 42D
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3712
Mailing Address - Country:US
Mailing Address - Phone:718-496-2473
Mailing Address - Fax:
Practice Address - Street 1:12711 MILAN WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1611
Practice Address - Country:US
Practice Address - Phone:301-805-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01943L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist