Fawad Hassan Viqar, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

024506 Issued in NY

Practice address

4 Smith Haven Mall Ste 107
Lake Grove, NY 11755-1219

Phone

(631) 444-8053

Fax

(631) 444-4267

NPI assigned

Feb 10, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1396499141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HARRISON DR",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211306",
            "telephone_number": "718-309-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SMITH HAVEN MALL STE 107",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551219",
            "telephone_number": "631-444-8053",
            "fax_number": "631-444-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIQAR",
        "first_name": "FAWAD",
        "middle_name": "HASSAN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024506",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "024506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Cerebral Palsy Association of Greater Suffolk, Inc
• United Cerebral Palsy Association of Greater Suffolk, Inc.
• Nancy Uribe, MS
• Maksim Vaysman, DO
• Joe Verghese, M.D.
• Lisa Joy Walters, MSED
• Joye Wang, DO
• Warby Parker Inc.
• Les Weinberg, PH.D.
• Deborah Weiss

• Clinical Neuropsychologist in Lake Grove, NY
• Providers in Lake Grove, NY by specialty
• Clinical Neuropsychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.