Individual
HOSAM ALDIN ALRQIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MSD, MA
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 342-8587
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 342-8587
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
000079-1
NY
1223D0001X
Public Health Dentistry
Primary
0401414639
VA
Other
Enumeration date
10/07/2014
Last updated
04/20/2017
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