Individual
AMEN WIQAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5189
(800) 836-7536
Mailing address
180 EXECUTIVE DR, NEW HYDE PARK, NY 11040-1016
(516) 884-9800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MT233791
PA
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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