Provider Demographics
NPI:1689294639
Name:QI, TERESA LEI (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LEI
Last Name:QI
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 1:11 JERNEE DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5309
Mailing Address - Country:US
Mailing Address - Phone:732-570-7851
Mailing Address - Fax:
Practice Address - Street 1:1621 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2604
Practice Address - Country:US
Practice Address - Phone:718-405-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program