Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 25MA05807600 | NJ |
NPI | 1003852542 |
---|---|
Provider Name | Dr. Tehsin Riaz Qudsi |
First Address | Jackson, NJ 08527-2524 |
Second Address | Jackson, NJ 08527-2524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 04/09/2015 |