Organization
MASOOM REHAB MEDICAL OFFICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD ASIF IQBAL M.D. (OWNER)
(646) 287-9406
Entity
Organization
Contact information
Practice address
79 CHURCH AVE, BROOKLYN, NY 11218-2207
(646) 287-9406
(718) 504-7966
Mailing address
5420 15TH AVE, 6H, BROOKLYN, NY 11219-4352
(646) 287-9406
(718) 504-7966
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02526350
—
NY
01
—
07228
GHI MEDICARE
NY
Enumeration date
12/06/2006
Last updated
08/22/2020
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