Provider Demographics
NPI:1528408366
Name:SYOSSET QUALITY CARE LLC
Entity Type:Organization
Organization Name:SYOSSET QUALITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEQIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-488-9427
Mailing Address - Street 1:15 MELANIE LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5831
Mailing Address - Country:US
Mailing Address - Phone:516-488-9427
Mailing Address - Fax:800-557-3140
Practice Address - Street 1:15 MELANIE LN
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-5831
Practice Address - Country:US
Practice Address - Phone:516-488-9427
Practice Address - Fax:800-557-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty