Provider Demographics
NPI:1407810740
Name:QUDSI, SOBIA A (MD)
Entity Type:Individual
Prefix:
First Name:SOBIA
Middle Name:A
Last Name:QUDSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOBIA
Other - Middle Name:
Other - Last Name:SAEED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 CAREY RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-7880
Mailing Address - Country:US
Mailing Address - Phone:518-761-0300
Mailing Address - Fax:518-824-2388
Practice Address - Street 1:87 PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6438
Practice Address - Country:US
Practice Address - Phone:518-536-7060
Practice Address - Fax:518-536-7075
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211552208000000X
NY211552-12080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01959448Medicaid