Individual
FAWAD HASSAN VIQAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4 SMITH HAVEN MALL STE 107, LAKE GROVE, NY 11755-1219
(631) 444-8053
(631) 444-4267
Mailing address
120 HARRISON DR, CENTERPORT, NY 11721-1306
(718) 309-5815
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
024506
NY
103TC0700X
Clinical Psychologist
024506
NY
Other
Enumeration date
02/10/2022
Last updated
01/27/2025
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