Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25MA10260000 | NJ |
N | 207K00000X | Allergist & Immunologist | 267950 | NY |
NPI | 1205135472 |
---|---|
Provider Name | Shaan M. Waqar |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Iselin, NJ 08830-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2011 |
Last Update Date | 01/04/2019 |