Provider Demographics
NPI:1023060910
Name:HAQUE, SAYERA (MD)
Entity type:Individual
Prefix:DR
First Name:SAYERA
Middle Name:
Last Name:HAQUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 NIXON CT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6502
Mailing Address - Country:US
Mailing Address - Phone:718-934-7502
Mailing Address - Fax:718-934-7502
Practice Address - Street 1:518 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3816
Practice Address - Country:US
Practice Address - Phone:718-633-4677
Practice Address - Fax:718-686-1114
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02610873Medicaid
NY0577S1Medicare ID - Type Unspecified
NYI 22568Medicare UPIN