Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 191212-1 | NY |
Y | 111NI0900X | Internist | 191212-1 | NY |
N | 207RC0200X | Critical Care Medicine | 191212-1 | NY |
N | 207RP1001X | Pulmonary Disease | 191212-1 | NY |
NPI | 1053306902 |
---|---|
Provider Name | Joseph Quist |
First Address | Brooklyn, NY 11203-2017 |
Second Address | Brooklyn, NY 11203-2017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 20/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E97516 | (02) | NY |