Provider Demographics
NPI:1518031228
Name:QADRI, SYED F (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:F
Last Name:QADRI
Suffix:
Gender:M
Credentials:MD
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 1347
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-0347
Mailing Address - Country:US
Mailing Address - Phone:570-288-8881
Mailing Address - Fax:570-288-8065
Practice Address - Street 1:50 MOISEY DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202
Practice Address - Country:US
Practice Address - Phone:570-501-6899
Practice Address - Fax:570-501-6897
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430379208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA821523OtherFIRST PRIORITY HEALTH
PA1019568440001Medicaid
PA001941893OtherHIGHMARK BLUE SHIELD
PA001941893OtherHIGHMARK BLUE SHIELD
PA821523OtherFIRST PRIORITY HEALTH