Provider Demographics
NPI:1831611425
Name:QDM ENTERPRISE INC
Entity type:Organization
Organization Name:QDM ENTERPRISE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADEWUNMI
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-287-5217
Mailing Address - Street 1:215 ACKERMAN ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-3601
Mailing Address - Country:US
Mailing Address - Phone:917-287-5217
Mailing Address - Fax:631-415-4420
Practice Address - Street 1:215 ACKERMAN ST
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-3601
Practice Address - Country:US
Practice Address - Phone:917-287-5217
Practice Address - Fax:631-415-4420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care