Provider Demographics
NPI:1376120964
Name:HAIDER, LUBAINA
Entity type:Individual
Prefix:
First Name:LUBAINA
Middle Name:
Last Name:HAIDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HICKSVILLE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3472
Mailing Address - Country:US
Mailing Address - Phone:646-501-3229
Mailing Address - Fax:
Practice Address - Street 1:22802 MERRICK BLVD FL 1
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-2105
Practice Address - Country:US
Practice Address - Phone:646-501-4950
Practice Address - Fax:929-455-9604
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332544207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine