Provider Demographics
NPI:1225169410
Name:VIQAR QUDSI,MD
Entity Type:Organization
Organization Name:VIQAR QUDSI,MD
Other - Org Name:DBA VALLEY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:VIQAR
Authorized Official - Middle Name:
Authorized Official - Last Name:QUDSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-566-6740
Mailing Address - Street 1:164 BOYNTON AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1241
Mailing Address - Country:US
Mailing Address - Phone:518-566-6740
Mailing Address - Fax:518-566-6904
Practice Address - Street 1:164 BOYNTON AVE
Practice Address - Street 2:STE 3
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1241
Practice Address - Country:US
Practice Address - Phone:518-566-6740
Practice Address - Fax:518-566-6904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA0493Medicare PIN