Basic Information
| Provider Information | |||||||||
| NPI: | 1225654981 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QASIM | ||||||||
| FirstName: | NEHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19840 HARPER AVE | ||||||||
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| City: | HARPER WOODS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482251804 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 19840 HARPER AVE | ||||||||
| Address2: | |||||||||
| City: | HARPER WOODS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482251804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3138819556 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2020 | ||||||||
| LastUpdateDate: | 05/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0019X | 5201010698 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |
No ID Information.