Healthcare Provider Details

I. General information

NPI: 1295296879
Provider Name (Legal Business Name): SYDNEY QUERFELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2373 G RD
GRAND JUNCTION CO
81505-1002
US

IV. Provider business mailing address

2373 G RD
GRAND JUNCTION CO
81505-1002
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-3061
  • Fax: 970-245-8369
Mailing address:
  • Phone: 970-243-3061
  • Fax: 970-245-8369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7916
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number7916
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0009531
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: