Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 119532 | NY |
Y | 207R00000X | Internist | 119532 | NY |
Y | 111NI0900X | Internist | 119532 | NY |
NPI | 1255491239 |
---|---|
Provider Name | Dr. Sohail A Qureshi |
First Address | Dansville, NY 14437-1717 |
Second Address | Dansville, NY 14437-1717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 22/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00469681 | (05) | NY |
100680BJ | PREFERRED CARE (01) | |
161550341 | AETNA (01) | |
161550341 | TRI CORE (01) | |
9708034 | GHI (01) | |
D79116 | (02) | |
P010119532 | BLUE CHOICE (01) | |
P010119532 | MONRO PLAN (01) | |
P020119532 | BLUE SHIELD (01) |