Provider Demographics
NPI:1366734436
Name:KHALIQUE, ZULFIQAR (MD)
Entity type:Individual
Prefix:
First Name:ZULFIQAR
Middle Name:
Last Name:KHALIQUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BELMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1804
Mailing Address - Country:US
Mailing Address - Phone:646-469-9596
Mailing Address - Fax:718-706-0777
Practice Address - Street 1:4757 43RD ST
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-6243
Practice Address - Country:US
Practice Address - Phone:718-706-1009
Practice Address - Fax:718-706-0777
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261413208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics