Provider Demographics
NPI:1831169473
Name:QU, WEIMIN (MD)
Entity type:Individual
Prefix:
First Name:WEIMIN
Middle Name:
Last Name:QU
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 1:13329 41ST RD
Mailing Address - Street 2:2A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3670
Mailing Address - Country:US
Mailing Address - Phone:718-888-0021
Mailing Address - Fax:718-228-6988
Practice Address - Street 1:13329 41ST RD
Practice Address - Street 2:2A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3670
Practice Address - Country:US
Practice Address - Phone:718-888-0021
Practice Address - Fax:718-228-6988
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226060207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02334458Medicaid
H70991Medicare UPIN
NY568C71Medicare ID - Type Unspecified