Provider Demographics
NPI:1508094533
Name:QURAISHI, IMRAN HABIB (MD, PHD)
Entity Type:Individual
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First Name:IMRAN
Middle Name:HABIB
Last Name:QURAISHI
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:360 STATE ST
Mailing Address - Street 2:APT 914
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3605
Mailing Address - Country:US
Mailing Address - Phone:203-785-3865
Mailing Address - Fax:203-737-2799
Practice Address - Street 1:800 HOWARD AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-4085
Practice Address - Fax:203-785-4937
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2015-06-30
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Provider Licenses
StateLicense IDTaxonomies
CTAY2629155-72212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology