Basic Information
Provider Information
NPI: 1720044134
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: QURESHI
FirstName: ABRAR
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 593 EDDY STREET, APC-10
Address2:  
City: PROVIDENCE
State: RI
PostalCode: 02903
CountryCode: US
TelephoneNumber: 4014447959
FaxNumber: 4014447144
Practice Location
Address1: 593 EDDY STREET, APC-10
Address2:  
City: PROVIDENCE
State: RI
PostalCode: 02903
CountryCode: US
TelephoneNumber: 4014447959
FaxNumber: 4014447144
Other Information
ProviderEnumerationDate: 04/25/2006
LastUpdateDate: 04/30/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X205049MAN Allopathic & Osteopathic PhysiciansDermatology 
207N00000X14522RIY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


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