Provider Demographics
NPI:1063493971
Name:QUALITY HEALTH CENTER
Entity Type:Organization
Organization Name:QUALITY HEALTH CENTER
Other - Org Name:QUALITY MOBILE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-465-3265
Mailing Address - Street 1:22005 94TH DR
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-2105
Mailing Address - Country:US
Mailing Address - Phone:718-465-3265
Mailing Address - Fax:
Practice Address - Street 1:22005 94TH DR
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-2105
Practice Address - Country:US
Practice Address - Phone:718-465-3265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32454122300000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01609301Medicaid