Provider Demographics
NPI:1457975674
Name:MA, QING
Entity Type:Individual
Prefix:DR
First Name:QING
Middle Name:
Last Name:MA
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:NYS CENTER OF EXCELLENCE IN BIOINFORMATICS AND LIFE SCI
Mailing Address - Street 2:701 ELLICOTT STREET
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203
Mailing Address - Country:US
Mailing Address - Phone:716-881-7500
Mailing Address - Fax:
Practice Address - Street 1:NYS CENTER OF EXCELLENCE IN BIOINFORMATICS AND LIFE SCI
Practice Address - Street 2:701 ELLICOTT STREET
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-881-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302041834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist