Provider Demographics
NPI:1659359271
Name:QURESHI, SHAHINA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHINA
Middle Name:M
Last Name:QURESHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10414 113TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2506
Mailing Address - Country:US
Mailing Address - Phone:718-835-2254
Mailing Address - Fax:718-835-9111
Practice Address - Street 1:10414 113TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419
Practice Address - Country:US
Practice Address - Phone:718-835-2254
Practice Address - Fax:718-835-9111
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133391-12080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00419172Medicaid
NY6B2571Medicare ID - Type Unspecified
NY00419172Medicaid