Provider Demographics
NPI:1114115508
Name:QURAISHY, KARYN LEE (MSPT)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:LEE
Last Name:QURAISHY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2646
Mailing Address - Street 2:6950 LA VALLE PLATEADA
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-2646
Mailing Address - Country:US
Mailing Address - Phone:858-759-6679
Mailing Address - Fax:858-759-6679
Practice Address - Street 1:6950 LA VALLE PLATEADA
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92067-2646
Practice Address - Country:US
Practice Address - Phone:858-759-6679
Practice Address - Fax:858-759-6679
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 22590174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist