Provider Demographics
NPI:1700230729
Name:QI, SHUQIANG
Entity Type:Individual
Prefix:
First Name:SHUQIANG
Middle Name:
Last Name:QI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7211 AUSTIN STREET, MB#194
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5354
Mailing Address - Country:US
Mailing Address - Phone:917-563-8610
Mailing Address - Fax:347-710-8806
Practice Address - Street 1:10714 71ST RD FL 1
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4719
Practice Address - Country:US
Practice Address - Phone:718-755-2999
Practice Address - Fax:347-710-8806
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040048225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist