Provider Demographics
NPI:1902394885
Name:QURESHI, HASSAN TARIQ (MD)
Entity Type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:TARIQ
Last Name:QURESHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HASSAN
Other - Middle Name:TARIQ
Other - Last Name:QURESHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:327 BEACH 19TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4423
Mailing Address - Country:US
Mailing Address - Phone:718-869-7000
Mailing Address - Fax:
Practice Address - Street 1:327 BEACH 19TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4423
Practice Address - Country:US
Practice Address - Phone:718-869-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2023-07-28
Deactivation Date:2018-11-29
Deactivation Code:
Reactivation Date:2018-12-18
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY3136852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program