Provider Demographics
NPI:1053100230
Name:ISHFAQ, QAMAR (PT)
Entity type:Individual
Prefix:
First Name:QAMAR
Middle Name:
Last Name:ISHFAQ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8460 123RD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3305
Mailing Address - Country:US
Mailing Address - Phone:929-478-1655
Mailing Address - Fax:929-478-1655
Practice Address - Street 1:8460 123RD ST FL 2
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3305
Practice Address - Country:US
Practice Address - Phone:929-478-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0533262251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics