Provider Demographics
NPI:1164600615
Name:QURESHI, MARCY LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARCY
Middle Name:LYNN
Last Name:QURESHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MARCY
Other - Middle Name:LYNN
Other - Last Name:COASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2139 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2336
Mailing Address - Country:US
Mailing Address - Phone:860-257-4131
Mailing Address - Fax:860-257-4519
Practice Address - Street 1:2400 TAMARACK AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5555
Practice Address - Country:US
Practice Address - Phone:860-644-4442
Practice Address - Fax:860-644-1412
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048828207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008022958Medicaid
CT2465560OtherAETNA
CT2018368OtherCIGNA
CT048828OtherCONNECTICARE
CT008022958Medicaid