Basic Information
| Provider Information | |||||||||
| NPI: | 1588083406 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QC MEDICAL CARE, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32 N 10TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110404203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9176172587 | ||||||||
| FaxNumber: | 7188836209 | ||||||||
| Practice Location | |||||||||
| Address1: | 9747 77TH ST | ||||||||
| Address2: | |||||||||
| City: | OZONE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114161902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9176172587 | ||||||||
| FaxNumber: | 7188836209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2014 | ||||||||
| LastUpdateDate: | 04/08/2014 | ||||||||
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| AuthorizedOfficialLastName: | CHOWDHURY | ||||||||
| AuthorizedOfficialFirstName: | QUASEM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9176172587 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 229329 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.