Provider Demographics
NPI:1023186442
Name:QUALITY MEDICAL PROVIDER PC
Entity Type:Organization
Organization Name:QUALITY MEDICAL PROVIDER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:S
Authorized Official - Last Name:QADRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DO,
Authorized Official - Phone:718-343-7790
Mailing Address - Street 1:191-11 FOOTHILL AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423
Mailing Address - Country:US
Mailing Address - Phone:718-343-7790
Mailing Address - Fax:718-343-7792
Practice Address - Street 1:267-01 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11004
Practice Address - Country:US
Practice Address - Phone:718-343-7790
Practice Address - Fax:718-343-7792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212993207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH00592Medicare UPIN
NY08139Medicare PIN