# 139 MEDICAL FACILITY P C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235301631
- **Authorized official:** DR. MUHAMMAD HAQUE JR. MD (DOCTOR)
- **Authorized official phone:** (212) 283-2099

## Contact information

- **Practice address:** 3418 BROADWAY, NEW YORK, NY 10031-7419
- **Practice address phone:** (212) 283-2099
- **Mailing address:** 3418 BROADWAY, NEW YORK, NY 10031-7419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 238067 | NY | Yes |
| 208000000X | Pediatrics Physician | 122027 | NY | — |

## Other

- **Enumeration date:** 03/26/2008
- **Last updated:** 08/04/2009