Basic Information
| Provider Information | |||||||||
| NPI: | 1770140717 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WASIQ | ||||||||
| FirstName: | SAAD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2233 6TH STREET | ||||||||
| Address2: | |||||||||
| City: | EAST MEADOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5713352932 | ||||||||
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| Practice Location | |||||||||
| Address1: | PSYCHIATRY DEPARTMENT | ||||||||
| Address2: | NASSAU UNIVERSITY MEDICIAL CENTRE | ||||||||
| City: | EAST MEADOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165726511 | ||||||||
| FaxNumber: | 5165723210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2019 | ||||||||
| LastUpdateDate: | 07/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.