Provider Demographics
NPI:1831155449
Name:QURESHI, YAHYA HAMEED (MD)
Entity type:Individual
Prefix:DR
First Name:YAHYA
Middle Name:HAMEED
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 1:12 CASE ST
Mailing Address - Street 2:STE 103
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360
Mailing Address - Country:US
Mailing Address - Phone:860-889-0147
Mailing Address - Fax:860-887-7255
Practice Address - Street 1:12 CASE ST
Practice Address - Street 2:STE 103
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-889-0147
Practice Address - Fax:860-887-7255
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010041161CT01OtherANTHEM BLUE CROSS
CT001411610Medicaid
CT001411610Medicaid
110008831Medicare ID - Type Unspecified