Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS16473 | FL |
Y | 207R00000X | Internist | OS16473 | FL |
Y | 111NI0900X | Internist | OS16473 | FL |
NPI | 1033103783 |
---|---|
Provider Name | Dr. John C Querci |
First Address | Jersey City, NJ 07302-8960 |
Second Address | Fort Myers, FL 33901-9303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 11/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7076455 | CIGNA (01) | FL |
826830 | (05) | FL |
B35488 | (02) | PA |