Provider Demographics
NPI:1790355444
Name:QURESHI, REHAN FARRUKH (MD)
Entity Type:Individual
Prefix:DR
First Name:REHAN
Middle Name:FARRUKH
Last Name:QURESHI
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 1:3900 CITY AVE APT M601
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2943
Mailing Address - Country:US
Mailing Address - Phone:905-541-4994
Mailing Address - Fax:
Practice Address - Street 1:2601 HOLME AVE BLDG 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2096
Practice Address - Country:US
Practice Address - Phone:267-350-7403
Practice Address - Fax:267-350-7441
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT223270207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine